Febrile urinary tract infection in men
Conditions
Interventions
Men with febrile urinary tract infection who are admitted for empirical intravenous antibiotic treatment will be switched to oral fosfomycin for a total treatment duration of 14 days
Sponsors
Haga Teaching Hospital
Eligibility
Inclusion criteria
Inclusion criteria: 1. Competent male patient aged 18 years or above 2. One or more symptom(s) suggestive of urinary tract infection (dysuria, frequency or urgency*; perineal or suprapubic pain; costo-vertebral tenderness or flank pain) 3. Fever (ear or rectal temp of 38.2 oC or higher, or axillary temp of 38 oC or higher), or history of feeling feverish with shivering or rigors in the past 24 hours 4. Positive urine nitrate test and/or leucocyturia as depicted by positive leukocyte esterase test or microscopy 5. Hospital admission for presumed FUTI and empirical intravenous antibiotic treatment with -lactams 6. Positive urine (> 103 CFU/ml) culture and/or blood culture with E. coli susceptible to fosfomycin, ciprofloxacin and the empirical intravenous -lactam treatment 7. Fulfilment of criteria for safe iv to oral switch (hemodynamic stability, ability to consume oral antibiotics, no gastrointestinal problems which affect absorption)
Exclusion criteria
Exclusion criteria: 1. Known allergy to fosfomycin or ciprofloxacin 2. Patients with known polycystic kidney disease 3. Patients on permanent renal replacement therapy (hemodialysis or peritoneal dialysis) 4. Patients with history of kidney transplantation 5. Patients with a permanent urinary catheter 6. Patients with chronic renal failure (eGFR < 30 ml/min/1.73m3) 7. Patients with renal abcess or pyonephrosis 8. Patients with chronic bacterial prostatitis (defined as recurrent UTI with the same uropathogen and no other clarifying underlying urological disorder) 9. Patients with any diagnosed metastatic E. coli foci 10. Patients with a double-J or nephrostomy catheter 11. Concomitant systemic antibiotic treatment for another reason than FUTI 12. Residence outside the Netherlands 13. Inability to speak or read Dutch
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary endpoint is the clinical cure rate 10-18 days post-treatment. | — |
Secondary
| Measure | Time frame |
|---|---|
| Test of Cure (10-18 days post-treatment): " bacteriologic cure rate " all-cause mortality " adverse events Late follow up (70- to 84 days post-treatment): " clinical cure rate " all-cause mortality " relapse rate of UTI | — |
Contacts
Public ContactC. Nieuwkoop, van
Haga Teaching Hospital, Dept. of Internal Medicine
Outcome results
None listed