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Clinical effects of 2 days of treatment by fosfomycin calcium for acute uncomplicated cystitis in women

  • Original Article
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Journal of Infection and Chemotherapy

Abstract

Fosfomycin calcium is a fosfomycin antimicrobial agent with a characteristic structure. After oral administration, the drug is absorbed and excreted via the kidneys in the unchanged form, without being metabolized in the body. It is, therefore, indicated for the treatment of urinary tract diseases, including cystitis and pyelonephritis. In the present study, the clinical usefulness of fosfomycin calcium (FOSMICIN® TABLETS 500) administered orally at the dosage of 1 g (two tablets) three times daily for 2 days was examined in female patients, who were at least 20 years of age, with acute uncomplicated cystitis of bacterial origin. Of the 48 patients enrolled between February 2008 and August 2008, 39 were evaluable for efficacy and safety. Overall evaluation of the cure revealed that microbiological eradication rate (microbiological outcome) and clinical efficacy rate (clinical outcome) at 5–9 days after drug administration (visit 2) were 94.9%. Determination of the microbiological and clinical outcomes for the evaluation of recurrence at 4–6 weeks after drug administration (visit 3) were 75.8 and 85.7%, respectively. Of the 48 patients, 40 (83.3%) returned to the clinic at visit 3. The causative bacterial species for cystitis was Escherichia coli in 31 (79.5%) of the 39 patients evaluable for efficacy and safety. Adverse drug reactions observed during the administration and follow-up periods included mild diarrhea and loose stools in 1 patient each, neither requiring any specific treatment. Evaluation of cure at visit 2 in patients in whom the causative bacterial species for the infection was E. coli revealed a microbiological outcome of 93.5%, and clinical outcome was 96.8%. Furthermore, evaluation for recurrence at visit 3 revealed a microbiological outcome of 74.1% and clinical outcome of 82.1%. When the patients were divided by age into an under 60 years of age group and an over 60 years of age group, the microbiological and clinical outcomes determined for evaluation of cure at visit 2 were 96.4 and 92.9%, respectively, and the corresponding rates determined for the evaluation of recurrence at visit 3 were 87.0 and 96.0%, respectively, in the under 60 years of age group. In the over 60 years of age group, the corresponding microbiological outcome and clinical outcome rates evaluated for cure were 90.9 and 100%, respectively, and those evaluated for recurrence were 50.0 and 60.0%, respectively. These results indicate the usefulness of fosfomycin calcium administered at 1 g three times daily for 2 days for acute uncomplicated cystitis.

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Acknowledgments

We express our sincere gratitude to the following investigators at the ten study institutions for participating in our study: Masafumi Ono at Ono Hospital, Hatsumi Masaki at Masaki Clinic, Fumio Higashino at Higashino Clinic, Tetsuo Iwami at Iwami Hospital, Koichi Murakawa at Murakawa Hospital, Kunihiro Yamanaka at Yamanaka Hospital, Yasushi Kano at Kano Medical Clinic, Hiromi Shiomi at Tsubota Hospital, Shuichi Kawai at Kawai Urologic Clinic, Shohei Nishi at Nishi Urologic and Dermatologic Clinic, and Toshihiro Ikeyama at Uenohara Clinic.

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Authors and Affiliations

  1. Department of Urology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan

    Tetsuro Matsumoto & Tetsuro Muratani

  2. Nakahama Clinic, 2-15-3 Nakamiya, Asahi-ku, Osaka, 535-0003, Japan

    Chikara Nakahama

  3. Division of Infection Control and Prevention, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Kazunori Tomono

Authors
  1. Tetsuro Matsumoto
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  2. Tetsuro Muratani
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  3. Chikara Nakahama
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  4. Kazunori Tomono
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Correspondence to Tetsuro Matsumoto.

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Matsumoto, T., Muratani, T., Nakahama, C. et al. Clinical effects of 2 days of treatment by fosfomycin calcium for acute uncomplicated cystitis in women. J Infect Chemother 17, 80–86 (2011). https://doi.org/10.1007/s10156-010-0092-2

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  • DOI: https://doi.org/10.1007/s10156-010-0092-2

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