Fosfomycin:: an underrated antibiotic for urinary tract infections due to Escherichia coli

OBJECTIVES. To evaluate the sensitivity patterns of Escherichia coli isolates obtained from urine specimens from patients with community-acquired urinary tract infections, with a special emphasis on fosfomycin trometamol for the treatment of UTI. METHODS. Retrospective analysis of the sensitivity pattern of 16,227 E. coli isolates recovered from urine cultures performed at the Microbiology Laboratory of Madrid Area 11 from 1997 to 2000. The antimicrobial agents tested included ampicillin, amoxycillin-clavulanate, cephalotin, cefuroxime, trimethoprim-sulphamethoxazol, fosfomycin trometamol, nitrofurantoin, and ciprofloxacin. Antibiotic sensitivity testing was performed with the Vitek automatic microdilution system (bioMerieux, France). RESULTS. E. coli represented 80.1% of all uropathogens recovered. The percentages of sensitive strains to ampicillin, amoxycillin-clavulanate, cephalotin, cefuroxime, trimethoprim-sulphamethoxazol, nitrofurantoin, and ciprofloxacin were 42.25%, 81.5%, 58.75%, 87.5%, 70%, 94.75%, and 84.75%, respectively. Fosfomycin trometamol was the antibiotic with the highest activity against E. coli, with 95.5% of sensitive isolates. CONCLUSIONS. Fosfomycin trometamol (single dose) is a good alternative that should be considered for the treatment of non-complicated lower urinary tract infections.