Comparing fosfomycin and ciprofloxacin for uncomplicated UTI treatment in adults: better bacterial eradication but non-significant clinical remission-a systematic review and meta-analysis
Abstract
BACKGROUND: Urinary tract infections (UTIs) are common in young children and women and even more so in pregnant women. Ciprofloxacin has been a long-used regime to treat UTIs, although recently the paradigm has shifted towards Fosfomycin. This shift is driven by rising antibiotic resistance, safety concerns with fluoroquinolones, and the need for alternative treatments with broader efficacy and fewer adverse effects. This systematic review and meta-analysis assess the effectiveness and safety of Fosfomycin compared to Ciprofloxacin for treating urinary tract infections in adults.
METHODS: A systematic search was conducted across PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar, and Scopus using search strings combining "Fosfomycin," "Ciprofloxacin," and "urinary tract infections." Study selection and screening were managed using Covidence, with duplicates removed. Four randomized controlled trials met the inclusion criteria following primary and secondary screening. Data analysis was performed using Review Manager (RevMan), with results presented as forest plots. A random-effects model was applied in cases of significant heterogeneity. The outcomes assessed included clinical remission, bacterial eradication, and adverse effects, based on data from three of the included studies.
RESULTS: Four studies matched our inclusion criteria and were processed further for analysis. For bacterial eradication, the total number of patients was 334 patients, bacterial…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 356 participants or records.
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