Three-Day Treatment With Pivmecillinam as Effective as 5 Days for Uncomplicated UTI: Presented at ECCMID

By Shazia Qureshi

AMSTERDAM, the Netherlands -- April 17, 2019 -- A study comparing 3 versus 5 days of treatment with pivmecillinam for acute uncomplicated urinary tract infection (UTI) found no difference in terms of clinical or bacteriological outcomes, suggesting that the 3-day course of treatment may be sufficient for patients, researchers reported here at the 29th European Congress of Clinical Microbiology & Infectious Diseases (ECCMID).

Of the 368 women with uncomplicated UTI who were randomised to either 3 days (n = 188) or 5 days (n = 180) of treatment with pivmecillinam, bacteriological success was achieved by 87% in the 3-day arm compared with 88% of women in the 5-day arm.

Bacteriological success was defined as a urine culture being negative for the UTI-causing bacteria within 7 to 21 days of the start of treatment.

There were significant differences between the 2 groups in terms of clinical outcomes. Patients in both groups reported a similar time to symptom resolution, at 2.94 ± 1.42 days in the 3-day arm versus 2.91 ± 1.46 days in the 5-day arm.

On day 4, similar proportions of patients reported resolution of their UTI symptoms in the 3-day and 5-day treatment groups (73% vs 76%). On day 28, this value was numerically higher in the 3-day group, but not statistically significantly (84% vs 74%; P = .060).

“A 3-day course of pivmecillinam 400 mg 3 times a day may be sufficient for acute uncomplicated UTI,” concluded Filip Jansåker, MD, Copenhagen University Hospital, and the University of Copenhagen, Copenhagen, Denmark.

[Presentation title: Three Versus Five Days of Pivmecillinam for Community-Acquired Acute Uncomplicated Cystitis: a Randomized, Double-Blind, Placebo-Controlled Trial. Abstract P1638]

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