EAGLE-3
Trial question
Is gepotidacin superior to nitrofurantoin in patients with uncomplicated UTI?
Study design
Multi-center
Double blinded
RCT
Population
541 female patients.
Inclusion criteria: adolescent and adult female patients with uncomplicated UTIs.
Key exclusion criteria: residence in nursing home or dependent care-type facility; history of sensitivity to study treatments; immunocompromised state; COPD; acute porphyria; any surgical or medical condition; G6PD deficiency.
Interventions
N=277 gepotidacin (an oral dose of 1,500 mg BID for 5 days).
N=264 nitrofurantoin (an oral dose of 100 mg BID for 5 days).
Primary outcome
Therapeutic success
58.5%
43.6%
58.5 %
43.9 %
29.3 %
14.6 %
0.0 %
Gepotidacin
Nitrofurantoin
Significant
increase ▲
NNT = 6
Significant increase in therapeutic success (58.5% vs. 43.6%; AD 14.6%, 95% CI 6.4 to 22.8).
Secondary outcomes
No significant difference in clinical success (67.9% vs. 63.3%; AD 4.4%, 95% CI -3.5 to 12.3).
Significant increase in microbiological success (72.2% vs. 57.2%; AD 15%, 95% CI 7.2 to 22.9).
Conclusion
In adolescent and adult female patients with uncomplicated UTIs, gepotidacin was superior to nitrofurantoin with respect to therapeutic success.
Reference
Florian Wagenlehner, Caroline R Perry, Thomas M Hooton et al. Oral gepotidacin versus nitrofurantoin in patients with uncomplicated urinary tract infection (EAGLE-2 and EAGLE-3): two randomised, controlled, double-blind, double-dummy, phase 3, non-inferiority trials. Lancet. 2024 Feb 24;403(10428):741-755.
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