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Commentary on: Huttner A, Kowalczyk A, Turjeman A, et al. Effect of 5-day nitrofurantoin vs single-dose fosfomycin on clinical resolution of uncomplicated lower urinary tract infection in women: a randomized clinical trial. JAMA. 2018; 319:1781–1789.
Uncomplicated urinary tract infection (UTI) is one of the most common indications for prescribing antibiotics in primary care. Although UTI is often self-limiting, most guidelines recommend antibiotics as the first-line treatment. Symptomatic treatment with pain killers has also been proven to be effective in women with uncomplicated UTI, even though this treatment strategy was still non-inferior to antibiotics.1–3 With increasing antibiotic resistance of UTI bacteria, determining the choice of the most effective and least harmful antibiotics has become crucial. In this context, antibiotics demonstrating low levels of resistance rates such as nitrofurantoin, pivmecillinam and …
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