Daily fosfomycin versus levofloxacin for complicated urinary tract infections

mBio. 2023 Oct 31;14(5):e0167723. doi: 10.1128/mbio.01677-23. Epub 2023 Sep 12.


Concerns over resistance and safety have been identified in the current treatment regimen for complicated urinary tract infections. Fosfomycin is a drug that is routinely used for the treatment of uncomplicated cystitis. This study shows that fosfomycin could be an oral alternative as step-down therapy for the treatment of complicated urinary tract infections, with a clinical cure rate comparable to levofloxacin but a lower microbiological success rate 3 weeks from start of antibiotics.

Keywords: complicated UTI; fosfomycin; oral antibiotic.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cystitis* / drug therapy
  • Fosfomycin* / therapeutic use
  • Humans
  • Levofloxacin / therapeutic use
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / microbiology


  • Fosfomycin
  • Levofloxacin
  • Anti-Bacterial Agents