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01-12-2024 | Fosfomycin | Original Article

Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection: a systematic review and network meta-analysis

Authors: Mohammed F. Hadidi, Nawaf Alhamami, Mohammed Alhakami, Ahmed S. Abdulhamid, Abdullah Alsharif, Mohammed S. Alomari, Yasir A. Alghamdi, Samirah Alshehri, Abdullah A. Ghaddaf, Faisal M. Alsenani, Hisham Almadani

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

Fosfomycin has been used more frequently in managing uncomplicated urinary tract infections (UTIs) due to decreased compliance and increased multidrug-resistant bacteria. The aim of this network meta-analysis was to assess the efficacy of Fosfomycin compared to Nitrofurantoin, Trimethoprim–Sulfamethoxazole (TMP-SMX), and Ciprofloxacin in terms of clinical and microbiological cure alongside with other measurements.

Materials and methods

We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). We included randomized control trials (RCTs) with uncomplicated UTI patients who received Fosfomycin, Nitrofurantoin, TMP-SMX, or Ciprofloxacin and reported the clinical or microbiological cure. We used Cochrane Risk of Bias Assessment Tool to assess the included studies’ quality. R-software was used for all statistical analysis. We ranked all antibiotics using the netrank function which yielded P scores. Frequentist network meta-analysis was used to assess the efficacy of all outcomes.

Results

We included 13 RCTs with a total number of 3856 patients that showed Fosfomycin ranked the highest among the other antibiotics with respect to clinical cure (P-score = 0.99) and microbiological cure (P-score = 0.99) while Ciprofloxacin ranked the lowest (P-score = 0.11 and 0.02, respectively). Moreover, Ciprofloxacin yielded the highest relapse rate (P-score = 1), whereas TMP-SMX had the lowest relapse rate (P-score = 0.07). As for the adverse events, Ciprofloxacin demonstrated the highest adverse events as opposed to Fosfomycin (P-score = 0.98 and 0.05, respectively).

Conclusion

The network meta-analysis demonstrated that Fosfomycin is the most effective antibiotic in treating uncomplicated UTIs with respect to clinical cure, microbiological cure, and adverse events profile.

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Title: Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection: a systematic review and network meta-analysis
Authors: Mohammed F. Hadidi
Nawaf Alhamami
Mohammed Alhakami
Ahmed S. Abdulhamid
Abdullah Alsharif
Mohammed S. Alomari
Yasir A. Alghamdi
Samirah Alshehri
Abdullah A. Ghaddaf
Faisal M. Alsenani
Hisham Almadani
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Fosfomycin
Nitrofurantoin
Ciprofloxacin
Urinary Tract Infection
Antibiotic
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04922-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Antibiotics efficacy in clinical and microbiological cure of uncomplicated urinary tract infection: a systematic review and network meta-analysis

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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