Fosfomycin: A First-Line Oral Therapy for Acute Uncomplicated Cystitis
Table 2
In vitro activities of orally prescribed antimicrobial agents against E. coli isolated from urine specimens in clinical laboratories across Canada from 2010 to 2013.
E. coli isolate phenotype (number tested)
Antimicrobial agent
MIC interpretation
% susceptible
% resistant
All E. coli (868)
Fosfomycin
99.4
0.1
Amoxicillin-clavulanate
81.3
5.7
Ciprofloxacin
77.4
22.5
Nitrofurantoin
96.1
1.5
TMP-SMX
74.7
25.3
TMP-SMX-resistant (219)
Fosfomycin
99.1
0
Amoxicillin-clavulanate
67.1
6.4
Ciprofloxacin
51.6
47.9
Nitrofurantoin
91.8
3.2
TMP-SMX
0
100
Ciprofloxacin-resistant (195)
Fosfomycin
97.9
0
Amoxicillin-clavulanate
66.0
6.7
Ciprofloxacin
0
100
Nitrofurantoin
91.3
4.1
TMP-SMX
45.9
54.1
ESBL-producing (42)
Fosfomycin
100
0
Amoxicillin-clavulanate
33.3
11.9
Ciprofloxacin
9.5
90.5
Nitrofurantoin
83.3
4.8
TMP-SMX
35.7
64.3
AmpC-producing (16)
Fosfomycin
100
0
Amoxicillin-clavulanate
6.3
87.4
Ciprofloxacin
75.0
25.0
Nitrofurantoin
100
0
TMP-SMX
75.0
25.0
Multidrug-resistant (15)
Fosfomycin
100
0
Amoxicillin-clavulanate
13.3
66.7
Ciprofloxacin
0
100
Nitrofurantoin
60.0
40.0
TMP-SMX
6.7
93.3
Data adapted from [9]. ESBL, extended-spectrum -lactamase; AmpC, chromosomal AmpC -lactamase; multidrug-resistant was defined as isolates resistant to ≥3 agents from different antimicrobial classes (amoxicillin-clavulanate, ciprofloxacin, nitrofurantoin, and TMP-SMX). TMP-SMX, trimethoprim-sulfamethoxazole.
