Uncomplicated urinary tract infections: preserving first-line antimicrobial agents in the updated guidelines

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Antimicrobial resistance (AMR) poses a global public health threat and may result in serious economic consequences. Although the treatment regimens for uncomplicated urinary tract infections (UTIs) have remained largely unchanged, they require continuous monitoring due to increasing antimicrobial resistance. The most recent updates of clinical guidelines for the management of uncomplicated UTIs did not revise the list of first-line antibiotics, since no new oral agents are currently available. Single-dose fosfomycin administration has been shown to be as safe and effective as other antibiotics in the treatment of uncomplicated UTIs in women. Fosfomycin therefore remains an adequate empirical treatment option. However, ongoing surveillance of regional antimicrobial resistance is essential to ensure the rational selection of antibiotics for empirical therapy.

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作者简介

Andrey Zaitsev

Russian University of Medicine, Ministry of Health of the Russian Federation

编辑信件的主要联系方式.
Email: zaitcevandrew@mail.ru
ORCID iD: 0000-0003-3044-1424

Ph.D., MD, professor, Department of Urology

俄罗斯联邦, Moscow

Lyubov Khodyreva

Research Institute for Healthcare Organization and Medical Management, Moscow City Health Department

Email: khodyreva60@mail.ru
ORCID iD: 0000-0002-0751-4982

Ph.D., MD, Head of the Organizational and Methodological Department of Urology

俄罗斯联邦, Moscow

Konstantin Kolontarev

Russian University of Medicine, Ministry of Health of the Russian Federation

Email: kb80@yandex.ru
ORCID iD: 0000-0003-4511-5998

Ph.D., MD, Deputy Head of the Moscow Urology Center, Botkin Clinical Hospital, Professor, Department of Urology

俄罗斯联邦, Moscow

Alexander Bernikov

Russian University of Medicine, Ministry of Health of the Russian Federation

Email: bernikov@mac.com
ORCID iD: 0000-0001-8361-585X

Ph.D., associate professor, Department of Urology

俄罗斯联邦, Moscow

参考

  1. Ventola C.L. The antibiotic resistance crisis: part 1: causes and threats. P T. 2015 Apr;40(4):277-83. PMID: 25859123; PMCID: PMC4378521..
  2. Jyoti Tanwar et al. Multidrug resistance: an emerging crisis. Interdiscip Perspect Infect Dis. 2014:2014:541340. doi: 10.1155/2014/541340.
  3. Antimicrobial Resistance Collaborators Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399:629–655. doi: 10.1016/S0140-6736(21)02724-0.
  4. The Lancet Antimicrobial resistance: an agenda for all. Lancet. 2024;403:2349. doi: 10.1016/S0140-6736(24)01076-6.
  5. WHO. World Health Organization; Geneva: Jan 1, 2016. Global action plan on antimicrobial resistance. https://iris.who.int/handle/10665/253236)
  6. WHO: 2020 antibacterial agents in clinical and preclinical development: an overview and analysis.
  7. Financial Times 21 Apr 2019.
  8. Hooton T.M., Stamm W.E. Diagnosis and treatment of uncomplicated urinary tract infection. Infect. Dis. Clin. North Am. 1997;11(3):551–81. https://dx.doi.org/10.1016/s0891-5520(05)70373-1.
  9. Rich S.N., Klann E.M., Almond C.R., Larkin E.M., Nicolette G., Ball J.D. Associations between antibiotic prescriptions and recurrent urinary tract infections in female college students. Epidemiol Infect. 2019;147:e119, 10.1017/s0950268818003369
  10. Hisano M., Bruschini H., Nicodemo A.C., Srougi M. Uncomplicated urinary tract infections in women in a Sao Paulo quaternary care hospital: bacterial spectrum and susceptibility patterns. Antibiotics (Basel). 2014;3:98–108, 10.3390/antibiotics3010098
  11. Aydin A., Ahmed K., Zaman I., Khan M.S., Dasgupta P. Recurrent urinary tract infections in women. Int. Urogynecol. J. 2015;26(6):795–804. https://dx.doi.org/10.1007/s00192-014-2569-5.
  12. Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect. Dis. Clin. North Am. 2014;28(1):1–13. https://dx.doi.org/10.1016/j.idc.2013.09.003.
  13. Nosseir S.B., Lind L.R., Winkler H.A. Recurrent uncomplicated urinary tract infections in women: a review. J. Womens Health (Larchmt). 2012;21(3):347–54. https://dx.doi.org/10.1089/jwh.2011.3056.
  14. Hooton T.M., Stapleton A.E., Roberts P.L., Winter C., Scholes D., Bavendam T., Stamm W.E. Perineal anatomy and urine-voiding characteristics of young women with and without recurrent urinary tract infections. Clin. Infect. Dis. 1999;29(6):1600–01. https://dx.doi.org/10.1086/313528.
  15. Bonkat G., Kranz J., Cai T. et al. EAU Guidelines on Urological Infections. Limited update march 2025.
  16. Stapleton A.E. The vaginal microbiota and urinary tract infection. Microbiol. Spectr. 2016; 4(6):10.1128/microbiolspec.UTI-0025-2016. https://dx.doi.org/10.1128/microbiolspec.UTI-0025-2016.
  17. Kozlov R.S., Palagin I.S., Ivanchik N.V., Trushin I.V., Dekhnich A.V., Eidelstein M.V., Perepanova T.S. et al. National Monitoring of Antibiotic Resistance of Outpatient Urinary Tract Infections in Russia: Results of the Multicenter Epidemiological Study DARMIS-2023. Clinical Microbiology and Antimicrobial Chemotherapy. 2024; 26(3):328-337. Russian (Козлов Р.С., Палагин И.С., Иванчик Н.В., Трушин И.В., Дехнич А.В., Эйдельштейн М.В., Перепанова Т.С. и др. Национальный мониторинг антибиотикорезистентности возбудителей внебольничных инфекций мочевых путей в России: результаты многоцентрового эпидемиологического исследования «ДАРМИС-2023». Клиническая микробиология и антимикробная химиотерапия. 2024; 26(3):328-337).
  18. Naber K.G., Bonkat G., Wagenlehner F.M.E. Руководства EAU и AUA/CUA/SUFU по рецидивирующим инфекциям мочевыводящих путей: в чем разница? Eur Urol. 2020;78(5):645–646. doi: 10.1016/j.eururo.2020.06.032.
  19. Ibishev K.S. Some aspects of treatment of persistent lower urinary tract infection in women. Urologiia. 2014;5:30–34. Russian (Ибишев Х.С. Некоторые аспекты лечения персистирующей инфекции нижних мочевых путей у женщин. Урология. 2014;5:30–34).
  20. Loran O.B. et al. An efficiency of fosfomycin trometamol for treatment of patients with chronic recurrent cystitis. Effectivnaya farmakoterapiya v urologii. 2008;4:15. Russian (Лоран О.Б. и др. Эффективность применения фосфомицина трометамола в лечении больных хроническим рецидивирующим циститом. Эффективная фармакотерапия в урологии. 2008;4:15).
  21. Zaitsev A.V., Kolontarev K.B. The role of phosphomycin in the treatment of urinary tract infections. Urology. 2017;4:91–96. https://dx.doi.org/10.18565/urol.2017.4.91-96. Russian (Зайцев А.В., Колонтарев К.Б. Роль фосфомицина в лечении инфекций мочевыводящих путей. Урология. 2017;4:91–96. https://dx.doi.org/10.18565/urol.2017.4.91-96).
  22. Zaitsev A.V., Palagin I.S. Phosphomycin: Potential and Possible Prospects for Use in Urological Practice. Urologiya. 2021;6:145–151 https://dx.doi.org/10.18565/urology.2021.6.145-151. Russian (Зайцев А.В., Палагин И.С. Фосфомицин: потенциал и возможные перспективы использования в урологической практике. Урология. 2021;6:145–151 https://dx.doi.org/10.18565/urology.2021.6.145-151).
  23. Zaitsev A.V., Davidov M.I. Results of treatment of acute uncomplicated cystitis in 440 women of working age in a large industrial city. Urology. 2025:2:35–43 https://dx.doi.org/10.18565/urology.2025.2.35-43. Russian (Зайцев А.В., Давидов М.И. Результаты лечения острого неосложненного цистита у 440 женщин трудоспособного возраста в крупном промышленном городе. Урология. 2025:2:35–43 https://dx.doi.org/10.18565/urology.2025.2.35-43).
  24. Perepanova T.S. Development of Clinical Guidelines «Cystitis in Women». Urology. 2022; 1:118-125. https://dx.doi.org/10.18565/urology.2022.1.118-125. Russian (Перепанова Т.С. Разработка клинических рекомендаций «Цистит у женщин». Урология. 2022; 1:118-125. https://dx.doi.org/10.18565/urology.2022.1.118-125).
  25. Zhanel G.G., Walkty A.J., Karlowsky J.A. Fosfomycin: A first-line oral therapy for acute uncomplicated cystitis. Can J Infect Dis Med Microbiol 2016. 2016:1–10. doi: 10.1155/2016/2082693.
  26. Cai T. et al. Rediscovering the value of fosfomycin trometamol in the era of antimicrobial resistance: A systematic review and expert opinion. Int J Antimicrob Agents. 2023;62(6):106983. doi: 10.1016/j.ijantimicag.2023.106983.
  27. Falagas M.E., Vouloumanou E.K., Samonis G., Vardakas K.Z. Fosfomycin. Clin Microbiol Rev. 2016;29:321–47. doi: 10.1128/CMR.00068-15.
  28. Verma T., Manhas G.S., Manhas R.S. Efficacy and Safety of Single-dose Fosfomycin for Uncomplicated Urinary Tract Infection in Women: Systematic Review and Meta-analysis. J Midlife Health. 2025;16(2):124–136. doi: 10.4103/jmh.jmh_77_24.
  29. R. Datta, M. Juthani-Mehta. Nitrofurantoin vs Fosfomycin: Rendering a Verdict in a Trial of Acute Uncomplicated Cystitis. JAMA. 2018;319(17):1771–1772. doi: 10.1001/jama.2018.4654.
  30. Asher Shafrir, Yonatan Oster, Michal Shauly-Aharonov, Jacob Strahilevitz. Real-Life Comparison of Fosfomycin to Nitrofurantoin for the Treatment of Uncomplicated Lower Urinary Tract Infection in Women. Biomedicines. 2023;11(4):1019. doi: 10.3390/biomedicines11041019.
  31. US Food and Drug Administration (FDA). FDA drug safety communication: FDA updates warnings for oral and injectable fluoroquinolone antibiotics due to disabling side effects. FDA, Silver Spring, MD (2016) https://www.fda.gov/media/99425/download. [accessed 2 February 2021]
  32. European Medicines Agency (EMA). Disabling and potentially permanent side effects lead to suspension or restrictions of quinolone fluoroquinolone antibiotics. EMA, Amsterdam, the Netherlands (2019) https://www.ema.europa.eu/en/documents/referral/quinolone-fluoroquinolone-article-31-referral-disabling-potentially-permanent-side-effects-lead_en.pdf. [accessed 2 February 2021]
  33. Bratsman A., Mathias K., Laubscher R., Grigoryan L., Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf. 2020;29:701–707. doi: 10.1002/pds.5018
  34. Cai T., Palagin I., Brunelli R., Liao Y., Lauderdale T., Kuo S. Office-based approach to urinary tract infections in 50 000 patients: results from the REWIND study. Int J Antimicrob Agents, 56 (2020), Article 105996, 10.1016/j.ijantimicag.2020.105996
  35. Hidalgo E., González-Torralba A., Ramón J., Alós J.-I. Maintained susceptibility to fosfomycin in extra-hospitalary urinary isolates of Escherichia coli. Strong association of fosfomycin resistance with age and ESBL production. Rev Esp Quimioter. 2025;38(1):55-58.
  36. Puttagunta S., Aronin S.I., Gupta J., Das A.F., Gupta K., Dunne M.W. Sulopenem versus Amoxicillin/Clavulanate for the Treatment of Uncomplicated Urinary Tract Infection. NEJM Evid. 2025;4(7). doi: 10.1056/EVIDoa2400414 VOL. 4 NO. 7.
  37. Wagenlehner F. et al. Oral gepotidacin versus nitrofurantoin in patients with uncomplicated urinary tract infection (EAGLE-2 and EAGLE-3): two randomised, controlled, double-blind, double-dummy, phase 3, non-inferiority trials. Lancet. 2024;403(10428):741–755. doi: 10.1016/S0140-6736(23)02196-7. Epub 2024 Feb 8.

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