Fosfomycin trometamol prophylaxis for recurrent urinary tract infections in male and female patients with urological comorbidities

OBJECTIVE: To study the efficacy of fosfomycin trometamol (FT) as prophylaxis for recurrent urinary tract infections (UTI) in a population not targeted by guidelines. METHODS: Retrospective, monocenter study of patients taking FT prophylaxis for recurrent UTI. We compared the incidence of UTI during the six months prior to and the six months following the initiation of prophylactic treatment with FT. RESULTS: a total of 86 patients were enrolled in the study, including 20 men and 66 women, with a median age of 56.5 years [44-70]. Forty-one had underlying urological diseases, and 24 were immunocompromised, including 16 kidney transplant recipients. FT prophylaxis was associated with a dramatic decrease in the incidence of UTI on multivariate analysis, with an incidence rate ratio of 0.15 [0.11-0.20] in women, and 0.05 [0.02-0.16] in men. Adverse events were reported by 12(13.9%) patients, leading to FT discontinuation in 3(3.4%). CONCLUSIONS: FT prophylaxis was associated with a 85-95% reduction in the incidence of UTI in patients with recurrent UTI and predisposing conditions.