{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:10:46Z","timestamp":1789726246091,"version":"4.0.1"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>\n                    In this meta-analysis and systematic review, the effectiveness and safety of single-dose fosfomycin were evaluated in comparison to other antibiotics for treating uncomplicated urinary tract infections (UTIs) in women, including asymptomatic bacteriuria (ASB) in pregnant women. Two independent reviewers conducted an electronic search on until December 2023 to search for randomized controlled trials that studied the efficacy and safety of fosfomycin for management of uncomplicated UTI in women or ASB in pregnant women and included those that fulfilled the eligibility criteria. The results showed that single-dose fosfomycin was comparable with other antibiotic agents in clinical resolution of uncomplicated UTI (odds ratio [OR]: 1.11, 95% confidence interval [CI] 0.88\u20131.41,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.37, moderate certainty). Moreover, single-dose fosfomycin was equal to other antibiotics in the microbiological resolution of uncomplicated UTI (OR: 1.02, 95% CI: 0.83\u20131.25,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 34%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.88, moderate certainty) and ASB among nonpregnant women (OR: 0.76, 95% CI: 0.45\u20131.28,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.30, moderate certainty). The incidence of adverse events too was similar in patients receiving fosfomycin or other antibiotics (OR: 0.97, 95% CI: 0.77\u20131.23,\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 41%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.82, moderate certainty). Administering a single dose of fosfomycin is just as safe and effective as other antibiotics in treating uncomplicated UTIs in women. Prescribing a single dose of fosfomycin (3 g) as a regular practice may result in higher compliance rates and a reduced likelihood of antibiotic resistance.\n                  <\/jats:p>","DOI":"10.4103\/jmh.jmh_77_24","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T06:00:17Z","timestamp":1750658417000},"page":"124-136","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy and Safety of Single-dose Fosfomycin for Uncomplicated Urinary Tract Infection in Women: Systematic Review and Meta-analysis"],"prefix":"10.4103","volume":"16","author":[{"given":"Tania","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Jammu, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav Singh","family":"Manhas","sequence":"additional","affiliation":[{"name":"Department of Radiology, Government Medical College, Jammu, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rameshwar Singh","family":"Manhas","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Government Medical College, Jammu, Jammu and Kashmir, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"issue":"Suppl 1","key":"R1-20250628","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1086\/318850","article-title":"Urinary tract infections: Disease panorama and challenges","volume":"183","author":"Stamm","year":"2001","journal-title":"J Infect Dis"},{"key":"R2-20250628","first-page":"359","article-title":"Recurrent urinary tract infections management in women: A review","volume":"13","author":"Al-Badr","year":"2013","journal-title":"Sultan Qaboos Univ Med J"},{"key":"R3-20250628","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1007\/s00108-017-0340-y","article-title":"Urinary tract infections: What has been confirmed in therapy?","volume":"58","author":"Marcon","year":"2017","journal-title":"Internist (Berl)"},{"key":"R5-20250628","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/j.eururo.2017.07.014","article-title":"Benefits and harms of treatment of asymptomatic bacteriuria: A systematic review and meta-analysis by the European Association of Urology Urological Infection Guidelines panel","volume":"72","author":"K\u00f6ves","year":"2017","journal-title":"Eur Urol"},{"key":"R6-20250628","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1086\/519268","article-title":"Population-based epidemiologic analysis of acute pyelonephritis","volume":"45","author":"Czaja","year":"2007","journal-title":"Clin Infect Dis"},{"key":"R7-20250628","first-page":"54","article-title":"Urinary tract infections in pregnancy","volume":"2","author":"Loh","year":"2007","journal-title":"Malays Fam Physician"},{"key":"R8-20250628","doi-asserted-by":"crossref","first-page":"30399","DOI":"10.2807\/1560-7917.ES.2016.21.46.30399","article-title":"ECDC publishes 2015 surveillance data on antimicrobial resistance and antimicrobial consumption in Europe","volume":"21","author":"Weist","year":"2016","journal-title":"Euro Surveill"},{"key":"R9-20250628","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1128\/CMR.00068-15","article-title":"Fosfomycin","volume":"29","author":"Falagas","year":"2016","journal-title":"Clin Microbiol Rev"},{"key":"R10-20250628","first-page":"1","article-title":"Fosfomycin: A first-line oral therapy for acute uncomplicated cystitis","author":"Zhanel","year":"2016","journal-title":"Can J Infect Dis Med Microbiol 2016"},{"key":"R11-20250628","first-page":"C26","article-title":"Comparative evaluation of fosfomycin activity with other antimicrobial agents against E. coli isolates from urinary tract infections","volume":"11","author":"Sardar","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"R12-20250628","first-page":"C06","article-title":"Fosfomycin: An alternative therapy for the treatment of UTI amidst escalating antimicrobial resistance","volume":"9","author":"Sabharwal","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"R13-20250628","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3399\/bjgpopen17X101097","article-title":"Cost-effectiveness of antibiotic treatment of uncomplicated urinary tract infection in women: A comparison of four antibiotics","volume":"1","author":"Sadler","year":"2017","journal-title":"BJGP Open"},{"key":"R14-20250628","first-page":"1466","article-title":"Uropathogenic Escherichia coli in a tertiary care hospital, Shimla, India","volume":"5","author":"Ganju","year":"2012","journal-title":"World J Pharm Pharm Sci"},{"key":"R15-20250628","doi-asserted-by":"crossref","first-page":"3631","DOI":"10.18203\/2320-6012.ijrms20173576","article-title":"Recent pattern of drug sensitivity of most commonly isolated uropathogens from Central India","volume":"5","author":"Lawhale","year":"2017","journal-title":"Int J Res Med Sci"},{"key":"R16-20250628","first-page":"23","article-title":"Drug utilization pattern and adverse drug reaction monitoring in urinary tract infection patients in a tertiary care hospital","volume":"5","author":"Fatima","year":"2015","journal-title":"J Drug Deliv Ther"},{"key":"R17-20250628","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"R18-20250628","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"R19-20250628","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1136\/ebm0005","article-title":"Making GRADE accessible: A proposal for graphic display of evidence quality assessments","volume":"16","author":"Khan","year":"2011","journal-title":"Evid Based Med"},{"key":"R20-20250628","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1007\/s00192-006-0190-y","article-title":"Is single-dose fosfomycin trometamol a good alternative for asymptomatic bacteriuria in the second trimesterof pregnancy?","volume":"18","author":"Bayrak","year":"2007","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R21-20250628","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s10156-010-0079-z","article-title":"Arandomized comparative study of single-dose fosfomycin and 5-day ciprofloxacin in female patients with uncomplicated lower urinary tract infections","volume":"16","author":"Ceran","year":"2010","journal-title":"J Infect Chemother"},{"issue":"Suppl 1","key":"R22-20250628","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1159\/000238815","article-title":"Single-dose fosfomycin trometamol versus multiple-dose cotrimoxazole in the treatment of lower urinary tract infections in general practice. Multicenter Group of General Practitioners","volume":"36","author":"Crocchiolo","year":"1990","journal-title":"Chemotherapy"},{"issue":"Suppl 1","key":"R23-20250628","first-page":"34","article-title":"A comparative double-blind randomised study of single dose fosfomycin trometamol with trimethoprim in the treatment of urinary tract infections in general practice","volume":"36","author":"Harvard","year":"1990","journal-title":"Chemotherapy"},{"key":"R24-20250628","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1159\/000282164","article-title":"Single-dose fosfomycin trometamol (Monuril) versus multiple-dose norfloxacin: Results of a multicenter study in females with uncomplicated lower urinary tract infections","volume":"46","author":"de Jong","year":"1991","journal-title":"Urol Int"},{"key":"R25-20250628","doi-asserted-by":"crossref","first-page":"2612","DOI":"10.1128\/AAC.38.11.2612","article-title":"Single-dose fosfomycin trometamol versus 5-day cephalexin regimen for treatment of uncomplicated lower urinary tract infections in women","volume":"38","author":"Elhanan","year":"1994","journal-title":"Antimicrob Agents Chemother"},{"key":"R26-20250628","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1007\/s10096-009-0805-6","article-title":"Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy","volume":"28","author":"Estebanez","year":"2009","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"R27-20250628","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1001\/jama.2018.3627","article-title":"effect of 5-day nitrofurantoin versus single-dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women: A randomized clinical trial","volume":"319","author":"Huttner","year":"2018","journal-title":"JAMA"},{"issue":"Suppl 2","key":"R28-20250628","doi-asserted-by":"crossref","first-page":"S89","DOI":"10.1007\/BF01643434","article-title":"A general practitioner multicenter study: Fosfomycin trometamol single dose versus pipemidic acid multiple dose","volume":"18","author":"Jardin","year":"1990","journal-title":"Infection"},{"key":"R29-20250628","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/S0924-8579(00)00351-4","article-title":"Treatment of lower urinary tract infection in pregnancy","volume":"17","author":"Krcmery","year":"2001","journal-title":"Int J Antimicrob Agents"},{"key":"R30-20250628","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0924-8579(98)00021-1","article-title":"A comparison between single-dose fosfomycin trometamol (Monuril) and a 5-day course of trimethoprim in the treatment of uncomplicated lower urinary tract infection in women","volume":"10","author":"Minassian","year":"1998","journal-title":"Int J Antimicrob Agents"},{"key":"R31-20250628","first-page":"53","article-title":"A comparison of the efficacy of a single dose fosfomycin trometamol versus a five-day nitrofurantoin regimen in the treatment of urinary tract infection among pregnant patients at FEU-NRMF Medical Center: A single bling randomized controlled trial","volume":"22","author":"Musa","year":"2016","journal-title":"Far Eastern University - NRMF Medical Journal"},{"issue":"Suppl 2","key":"R32-20250628","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1007\/BF01643431","article-title":"Fosfomycin trometamol versus ofloxacin\/co-trimoxazole as single dose therapy of acute uncomplicated urinary tract infection in females: A multicentre study","volume":"18","author":"Naber","year":"1990","journal-title":"Infection"},{"issue":"Suppl 1","key":"R33-20250628","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1159\/000238810","article-title":"Fosfomycin trometamol versus amoxicillin \u2013Single-dose multicenter study of urinary tract infections","volume":"36","author":"Neu","year":"1990","journal-title":"Chemotherapy"},{"key":"R34-20250628","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/BF01871127","article-title":"Fosfomycin trometamol in a single dose versus seven days nitrofurantoin in the treatment of acute uncomplicated urinary tract infections in women","volume":"15","author":"Van Pienbroek","year":"1993","journal-title":"Pharm World Sci"},{"issue":"Suppl 2","key":"R35-20250628","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1007\/BF01643432","article-title":"Single dose fosfomycin trometamol versus multiple dose norfloxacin over three days for uncomplicated UTI in general practice","volume":"18","author":"Reynaert","year":"1990","journal-title":"Infection"},{"issue":"Suppl 1","key":"R36-20250628","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000238813","article-title":"Fosfomycin trometamol (Monuril) versus norfloxacin in single dose for adult female uncomplicated UTIs. Multicenter randomized, double-blind study","volume":"36","author":"Selvaggi","year":"1990","journal-title":"Chemotherapy"},{"key":"R37-20250628","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1016\/S0149-2918(00)86734-X","article-title":"Comparison of single-dose fosfomycin and a 7-day course of nitrofurantoin in female patients with uncomplicated urinary tract infection","volume":"21","author":"Stein","year":"1999","journal-title":"Clin Ther"},{"key":"R38-20250628","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ajog.2017.08.070","article-title":"A randomized controlled trial on the efficacy and safety profile of single oral dose of fosfomycin tromethamine versus cefuroxime axetil in the treatment of asymptomatic bacteriuria among pregnant women","volume":"217","author":"Taladtad","year":"2017","journal-title":"Am J Obstet Gynecol"},{"issue":"Suppl 2","key":"R39-20250628","doi-asserted-by":"crossref","first-page":"S94","DOI":"10.1007\/BF01643435","article-title":"Single dose fosfomycin trometamol versus multiple dose nitrofurantoin in pregnant women with bacteriuria: Preliminary results","volume":"18","author":"Thoumsin","year":"1990","journal-title":"Infection"},{"key":"R40-20250628","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.ijgo.2011.03.014","article-title":"Comparison of single-dose and multiple-dose antibiotics for lower urinary tract infection in pregnancy","volume":"114","author":"Usta","year":"2011","journal-title":"Int J Gynaecol Obstet"},{"issue":"Suppl 1","key":"R41-20250628","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000238818","article-title":"Fosfomycin trometamol versus pipemidic acid in the treatment of bacteriuria in pregnancy","volume":"36","author":"Zinner","year":"1990","journal-title":"Chemotherapy"},{"key":"R42-20250628","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.1007\/s40265-013-0143-y","article-title":"Fosfomycin trometamol: A review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria","volume":"73","author":"Keating","year":"2013","journal-title":"Drugs"},{"key":"R43-20250628","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1136\/bmjebm-2018-111063","article-title":"Single-dose fosfomycin is less effective than 5-day nitrofurantoin in women with uncomplicated urinary tract infection: Closing the evidence gap for a new recommendation of an old antibiotic","volume":"24","author":"G\u00e1gyor","year":"2019","journal-title":"BMJ Evid Based Med"},{"key":"R44-20250628","first-page":"CD000491","article-title":"Duration of treatment for asymptomatic bacteriuria during pregnancy","author":"Widmer","year":"2015","journal-title":"Cochrane Database Syst Rev 2015"},{"key":"R45-20250628","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jiac.2016.01.010","article-title":"Fosfomycin: Resurgence of an old companion","volume":"22","author":"Sastry","year":"2016","journal-title":"J Infect Chemother"},{"key":"R46-20250628","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijantimicag.2018.09.013","article-title":"Resistance to fosfomycin: Mechanisms, frequency and clinical consequences","volume":"53","author":"Falagas","year":"2019","journal-title":"Int J Antimicrob Agents"},{"key":"R47-20250628","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.jiph.2019.05.012","article-title":"Oral treatment options for patients with urinary tract infections caused by extended spectrum ?eta-lactamase (ESBL) producing Enterobacteriaceae","volume":"12","author":"Raja","year":"2019","journal-title":"J Infect Public Health"},{"key":"R48-20250628","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/S1413-8670(11)70151-9","article-title":"Fosfomycin in vitro resistance of Escherichia coli from the community","volume":"15","author":"Biondo","year":"2011","journal-title":"Braz J Infect Dis"},{"key":"R49-20250628","doi-asserted-by":"crossref","first-page":"843","DOI":"10.2147\/TCRM.S3426","article-title":"Levofloxacin in the treatment of complicated urinary tract infections and acute pyelonephritis","volume":"4","author":"McGregor","year":"2008","journal-title":"Ther Clin Risk Manag"}],"container-title":["Journal of Mid-life Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_77_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:34:06Z","timestamp":1787067246000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmh.jmh_77_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":48,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jmh.jmh_77_24","relation":{},"ISSN":["0976-7800","0976-7819"],"issn-type":[{"value":"0976-7800","type":"print"},{"value":"0976-7819","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-04-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-05","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}