Single-Dose Fosfomycin Trometamol Versus Other Antimicrobial Regimens for the Treatment of Uncomplicated Lower UTI

Mubarak Alfaresi*, Kawther Hassan, Rafi Mahmoud Hindi Alnjadat
College of medicine, University of Sharjah, UAE



Uncomplicated lower urinary tract infections (LUTIs) are the most common source of infection affecting women. The increasing prevalence of antimicrobial resistance to commonly prescribed antibiotics has led to the development and use of novel therapies. This current meta-analysis and systematic review evaluate the use of single-dose fosfomycin-trometamol (FMT) versus alternative antimicrobial regimens in the management of uncomplicated LUTI.


This is a systematic review. We included observational studies and randomized controlled trials (RCTs). Studies that investigated the efficacy of fosfomycin or FMT in managing uncomplicated LUTIs in any age group or gender and compared the treatment to any alternative antibiotic regimen were considered eligible.


After a comprehensive review of the literature, nineteen studies fulfilled the inclusion criteria. All of the eligible studies (3779 patients) investigated showed no difference between the use of single-dose fosfomycin versus alternative antibiotic regimens for LUTI treatment (OR, 1.003; 95% CI, 0.853–1.181; p = 0.967). The OR remained unchanged but became statistically significant when the random-effects model was used for sensitivity analysis (OR, 1.53; 95% CI, 1.05–2.38; p = 0.04).


The meta-analysis revealed that there was no significant difference between single-dose FMT and the commonly prescribed antibiotic regimens in LUTI treatment outcomes such as clinical improvement and microbial eradication.

Keywords: Fosfomycin Trometamol, Antimicrobial, Lower Urinary tract infection.

Abstract Information

Identifiers and Pagination:

Year: 2019
Volume: 13
Publisher Item Identifier: EA-TOMICROJ-2018-45

Article History:

Received Date: 01/01/2019
Revision Received Date: 06/05/2019
Acceptance Date: 13/05/2019
Electronic publication date: 18/06/2019
Collection year: 2019

© 2019 Alfaresi et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the College of medicine, University of Sharjah, UAE; Tel: +971504411755; Email: