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Acquisition, analysis, or interpretation of data: Huttner, Kowalczyk, Turjeman, Babich, Brossier, Eliakim-Raz, Kosiek, Martinez de Tejada, Roux, Schiber, von Dach, Yahav, Leibovici, Godycki-Ćwirko, Mouton, Harbarth. Main exclusion criteria were pregnancy and lactation; suspected upper UTI (presence of fever, chills, or flank pain); antibiotic use or any symptoms consistent with UTI in the preceding 4 weeks; indwelling urinary catheter or otherwise complicated UTI; immunosuppression (untreated infection with HIV, ongoing chemotherapy or radiation therapy, use of high-dose corticosteroids or other immunosuppressive medication); and renal insufficiency (creatinine clearance <30 mL/min). Adverse events were few and primarily gastrointestinal; the most common were nausea and diarrhea (7/248 [3%] and 3/248 [1%] in the nitrofurantoin group vs 5/247 [2%] and 5/247 [1%] in the fosfomycin group, respectively). Multiple requests from the same IP address are counted as one view. Dr Kosiek reported receiving grants from the European Commission and the Ministry of Science and Higher Education. Her recurrent strain was also resistant to fosfomycin, but the initial strain’s susceptibility to this antibiotic was not tested. those of the individual authors and contributors and not of the publisher and the editor(s). Participants were randomized in a 1:1 ratio to oral nitrofurantoin, 100 mg 3 times a day for 5 days (n = 255), or a single 3-g dose of oral fosfomycin (n = 258). eAppendix. Of the 487 baseline urine cultures obtained, 377 (77%) were positive (Table 2; eTable 1 in Supplement 3). Within the ITT population, receipt of the study intervention was confirmed among 494 women (96%), with thereafter 20 patients lost to follow-up, so that ultimately 474 (92%) composed the per-protocol population.  HD. Supervision: Huttner, Martinez de Tejada, Theuretzbacher, Leibovici, Godycki-Ćwirko, Harbarth. In both trials, a reduction in urine culture counts from 105 to 104 cfu/mL qualified as microbiologic success. Get free access to newly published articles. Borsa What is the effect of 5-day nitrofurantoin, compared with single-dose fosfomycin, on clinical resolution of uncomplicated lower urinary tract infection (UTI) in women? Rupak Datta, MD, PhD; Manisha Juthani-Mehta, MD, Antibiotic Treatment for Uncomplicated Urinary Tract Infections, Antibiotic Treatment for Uncomplicated Urinary Tract Infections—Reply, Angela Huttner, MD; Leonard Leibovici, MD; Stephan Harbarth, MD, Emergence of Resistance Among Patients With Bacteriologic Recurrence.  A, Klimberg Findings  Multiple imputation using chained equations: issues and guidance for practice. https://doi.org/10.3390/ani11020510, Pérez-Ciria, Leticia; Carcò, Giuseppe; Miana-Mena, Francisco J.; Mitjana, Olga; Falceto, María V.; Latorre, Maria A. White See further details. All Rights Reserved. Mazzei Animals. Among these, E coli (230/377 [61%]), Klebsiella spp (27/377 [7%]), Enterococcus spp (27/377 [7%]), and Proteus spp (17/377 [5%]) predominated. Bacteriologic Response Among Patients With E. coli in Baseline Urine Cultures, eTable 8. Women’s quality of life is decreased by acute cystitis and antibiotic adverse effects associated with treatment. The primary outcome was clinical response in the 28 days following therapy completion, defined as clinical resolution (complete resolution of symptoms and signs of UTI without prior failure), failure (need for additional or change in antibiotic treatment due to UTI or discontinuation due to lack of efficacy), or indeterminate (persistence of symptoms without objective evidence of infection). Huttner A, Kowalczyk A, Turjeman A, et al.  G, Maugeri Conversely, only in Geneva was any baseline resistance to study drugs detected among Klebsiella spp, with 3 of 10 (30%) and 2 of 10 (20%) strains resistant to nitrofurantoin and fosfomycin, respectively.  D.  Experience with fosfomycin for treatment of urinary tract infections due to multidrug-resistant organisms. Since this is my favourite class, and I've picked up some good strategies for it, here is a guide to being a mage, from the start to the end. Microbiologic resolution occurred in 129 of 175 (74%) vs 103 of 163 (63%), respectively (difference, 11% [95% CI, 1%-20%]; P = .04). By continuing to use our site, or clicking "Continue," you are agreeing to our, Figure. In communities using fosfomycin regularly, significant increases in resistance have been observed, as demonstrated in Spain in 2008.8 The single-dose regimen may be insufficient1,5 for effective bactericidal activity given the drug’s at least partially time-dependent killing9,10 and the high interindividual variability observed in urinary concentrations.11. Gupta Additional Contributions: We thank all trial participants for their efforts and Ilker Uçkay, MD, and Virginie Prendki, MD, for their help in recruitment and Angèle Gayet-Ageron, MD, PhD, for statistical support including mixed effects modeling and multiple imputation; all are with Geneva University Hospitals and none received compensation. Voided midstream urine specimens were collected in sterile containers and transported within 24 hours to each site’s central laboratory, where specimens were cultured according to published recommendations.17 Cultures were reported to be positive when 103 cfu/mL or more of at least 1 bacterium was detected (see the eAppendix in Supplement 3 for more details).  LG, Cousins Women in Lodz tended to be older and to have taken antibiotics more frequently in the year prior to inclusion as compared with those in Geneva and Petah-Tiqva. MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Gilts were allocated to four experimental treatments (, This is an open access article distributed under the, Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers.  ME, Hoehns The ITT population consisted of all patients randomized to either study antibiotic and the per-protocol population of those who took the study antibiotic with at least 80% adherence and for whom no major protocol deviations were documented.  S, Arrigucci In this trial, we concluded that gilt immunocastration is positive, increasing carcass fatness and decreasing reproductive tract development. Assignments were concealed from study investigators via opaque sealed envelopes until patient enrollment, and allocated treatment to either nitrofurantoin or fosfomycin in a 1:1 ratio. Maraki Immunoglobulins are major components of what is called the humoral immune response system. There were no urosepsis events, and no lost days of work due to hospital admission (5/7 patients with pyelonephritis were retired; the remaining 2 were treated as outpatients).