A randomized trial comparing single-dose therapy with fosfomycin trometamol 3 g versus amoxycillin 3 g was carried out in four centers. There were 158 female patients between 18 and 65 years. The major infecting organism in both groups was Escherichia coli (80%). The overall evaluation showed that fosfomycin trometamol eradicated 81.2% of bacteria and amoxycillin 71.8%. In women younger than 45 years, the cure rate was 88.8% for fosfomycin trometamol and 72.9% for amoxycillin. There was more persistence in the amoxycillin group, but equal recurrence and reinfection for both agents. The most common failure was with E. coli for both agents. Side effects were minimal with 8.7% for fosfomycin trometamol and 11.5% for amoxycillin. Fosfomycin trometamol is effective therapy of acute urinary tract infections in adult females and in selected situations was superior to amoxycillin.

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