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Urinary Tract InfectionsPhase 4SCOUTNCT04959331

Clinical Effectiveness and Bacteriological Eradication of 4 Short-course Antibiotics for Uncomplicated UTIs in Women.

A Phase 4 study testing Fosfomycin Trometamol Salt, Nitrofurantoin and Pivmecillinam in people with Urinary Tract Infections, run by Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina at 33 sites in Spain.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Randomized clinical trial in which women aged 18 or older and with symptoms of uncomplicated lower urinary tract infection and a positive urine dipstick analysis will be randomized to one of the following four groups: 2-day 3 g fosfomycin o.d., 3-day pivmecillinam 400 mg. t.i.d, 5-day nitrofurantoin 100 mg t.i.d. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Urinary Tract Infections
What is being tested?
Fosfomycin Trometamol Salt, Nitrofurantoin and Pivmecillinam
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,000 participants
Where
33 sitesSpain
Study dates
2 Nov 2021to 31 Dec 2024
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Women of 18 years of age or older, with clinical features of uncomplicated community-acquired lower urinary tract infection including:
  • At least one of four key symptoms of lower urinary tract infection: dysuria, urgency including nycturia, frequency, and suprapubic tenderness that could be attributed to an uncomplicated lower urinary tract infection, and no alternative explanation (i.e. symptoms suggestive of sexually-transmitted infection or vulvovaginitis), and
  • A urine dipstick analysis positive for either nitrites or leukocyte esterase.

Who cannot join

  • Male sex
  • High suspicion of pyelonephritis (i.e. fever ≥ 37.5°C or flank pain/tenderness)
  • Any condition that may lead or predispose to complicated urinary infection (i.e. indwelling urinary catheter, pregnancy, immunosuppressive therapy, abnormal urinary tracts, recurrent urinary tract infection, severe neurological disease affecting the bladder)
  • Pregnancy or planned pregnancy
  • Symptoms consistent with urinary tract infection in the preceding 4 weeks
  • Patients taking long-term antibiotic prophylaxis
Show all 20Show fewer
  • Ongoing antibiotic therapy or use of any systemic antibiotic in the previous 7 days
  • Symptoms correlating with differential diagnosis (i.e. vaginal discharge or pain)
  • Hypersensitivity or allergy to β lactams, nitrofurantoin and/or fosfomycin
  • Moderate to severe chronic renal insufficiency
  • Pre-existing polyneuropathy
  • History of lung or liver reaction or peripheral neuropathy after previous use of nitrofurantoin
  • Glucose-6-phosphate dehydrogenase deficiency
  • Porphyria or systemic primary carnitine deficiency or of the type organic aciduria (i.e. methylmalonic aciduria and propionicacidaemia)
  • Esophageal stricture
  • Current intake of allopurinol or probenecid or valproate
  • Currently part of another randomized clinical trial
  • Previous enrolment in the proposed study
  • Patients living in long-term institutions; and/or
  • Difficulty in conducting scheduled follow-up visits

Trial locations and contacts

33 sites in 1 country.

33 sites in 1 country

Spain33 sites
  • Banyoles Center

    Banyoles, Catalonia, 17820

  • Calatayud Center

    Calatayud, Aragon, 50300

  • Santa Ponça Health Center

    Calvià, Balearic Islands, 07180

  • Corbera Center

    Corbera de Llobregat, Catalonia, 08757

  • La Gavarra Health Center

    Cornellà de Llobregat, Catalonia, 08940

  • El Puerto Center

    Coslada, Madrid, 28821

  • Valleaguado Health Center

    Coslada, Madrid, 28823

  • 17 de Setembre Center

    el Prat de Llobregat, Catalonia, 08820

  • Can Vidalet Center

    Esplugues de Llobregat, Catalonia, 08950

  • Santa Clara Center

    Girona, Catalonia, 17001

  • Florida Center

    L'Hospitalet de Llobregat, Catalonia, 08905

  • Can Serra Center

    L'Hospitalet de Llobregat, Catalonia, 08906

  • Los Alpes Health Center

    Madrid, Madrid, 28022

  • Aquitania Health Center

    Madrid, Madrid, 28032

  • Mar Báltico Center

    Madrid, Madrid, 28033

  • Buenos Aires Center

    Madrid, Madrid, 28038

  • Montblanc Center

    Montblanc, Catalonia, 43400

  • Emili Darder Center

    Palma de Mallorca, Balearic Islands, 07007

  • Camp Redó Health Center

    Palma de Mallorca, Balearic Islands, 07010

  • Son Pisà Center

    Palma de Mallorca, Balearic Islands, 07011

  • Son Serra-La Vileta Health Center

    Palma de Mallorca, Balearic Islands, 07013

  • Pere Garau Center

    Palma de Mallorca, Catalonia, 07007

  • San Fernando Health Center

    San Fernando de Henares, Madrid, 28830

  • Molí Nou Center

    Sant Boi de Llobregat, Catalonia, 08830

  • Sant Feliu de Guíxols Center

    Sant Feliu de Guíxols, Catalonia, 17220

  • Sant Just Desvern Center

    Sant Just Desvern, Catalonia, 08960

  • Vila Vella Center

    Sant Vicenç dels Horts, Catalonia, 08620

  • Santa Maria del Camí Center

    Santa Maria del Camí, Balearic Islands, 07320

  • Jaume I Health Center

    Tarragona, Catalonia, 43005

  • Villarejo de Salvanés Health Center

    Villarejo de Salvanés, Madrid, 28590

  • Las Fuentes Center

    Zaragoza, Aragon, 50002

  • Arrabal Health Center

    Zaragoza, Aragon, 50015

  • Parque Goya Health Center

    Zaragoza, Aragon, 50018

Other trials in Spain

About this study

Official title: Clinical Effectiveness and Bacteriological Eradication of Three Different Short-course Antibiotic Regimens and Single-dose Fosfomycin for Uncomplicated Lower Urinary Tract Infections in Adult Women.

Randomized clinical trial in which women aged 18 or older and with symptoms of uncomplicated lower urinary tract infection and a positive urine dipstick analysis will be randomized to one of the following four groups: 2-day 3 g fosfomycin o.d., 3-day pivmecillinam 400 mg. t.i.d, 5-day nitrofurantoin 100 mg t.i.d. or a single dose of 3 g of fosfomycin. Sample: 1,000 patients. Two co-primary endpoints are considered: clinical effectiveness at day 7 and bacteriological eradication at day 14. Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed.

Read the detailed description

Uncomplicated lower urinary tract infections (LUTI) represent a common problem in primary care. Resistance of uropathogens to common antibiotics has significantly increased in the last years. Current local guidelines recommend the use of a single 3 g dose of fosfomycin for these infections, but most general practitioners prefer short-course therapies to single-dose therapy. No study has compared head-to-head short course antimicrobial agents for uncomplicated LUTIs. Therefore, the aim of this randomized clinical trial is to compare three different short-course antibiotic therapies with single-dose fosfomycin for uncomplicated LUTIs in adult women. This will be a pragmatic, multicenter, parallel group, open randomized trial. Women aged 18 or older and with symptoms of uncomplicated LUTI and a positive urine dipstick analysis will be randomized to one of the following four groups: 2-day 3 g fosfomycin o.d., 3-day pivmecillinam 400 mg. t.i.d, 5-day nitrofurantoin 100 mg t.i.d. or a single dose of 3 g of fosfomycin. Sample: 1,000 patients. Two co-primary endpoints are considered: clinical effectiveness, defined as resolution of symptoms, answered by the patients at day 7, and bacteriological eradication (proportion of patients bacteriologically cured) at day 14. Patients will be given a symptom diary for seven days. Follow-up visits are scheduled at days 7 (phone call), 14 and 28 for assessing evolution. Urine samples will be collected in the three on-site visits and urine cultures performed. If positive, antibiograms for the 3 antibiotics studied will be performed.

Being tested
Fosfomycin Trometamol Salt, Nitrofurantoin, Pivmecillinam
Keywords
Urinary Tract Infections, Women, Patient Outcome Assessment, Bacteriological Eradication, Urinalysis, Anti-Bacterial Agents, Antimicrobial Resistance, Short Course, Primary Health Care
Medical subject headings
Urinary Tract Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fosfomycin Trometamol SaltDrug

    Also called Monurol

    Fosfomycin 3 g 2 sachets, taken orally, once daily for two days

  • NitrofurantoinDrug

    Also called Furantoin

    Nitrofurantoin 50 mg pills, taken orally, two pills/8 hours, for five days

  • PivmecillinamDrug

    Also called Selexid

    Pivmecillinam 400 mg pills. taken orally, one pill/8 hours, for three days

  • Fosfomycin Trometamol SaltDrug

    Also called Monurol

    Fosfomycin 3 g one sachet, taken orally, for one day

Study groups in NCT04959331
Study groupRoleWhat they receive
Short-course fosfomycinActive comparator3 g of fosfomycin once daily for two days (sachets)
Receives: Drug: Fosfomycin Trometamol Salt
Short-course nitrofurantoinActive comparatorFive-day nitrofurantoin 100 mg t.i.d. (pills)
Receives: Drug: Nitrofurantoin
Short-course pivmecillinamActive comparatorThree-day pivmecillinam 400 mg. t.i.d. (pills)
Receives: Drug: Pivmecillinam
Single-dose fosfomycinActive comparatorSingle 3 g dose of fosfomycin (sachet)
Receives: Drug: Fosfomycin Trometamol Salt

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Clinical effectiveness.

    Proportion of patients who report being cured, defined as the resolution of the four symptoms, scoring 0 in the symptom diary.

    Measured: Day 7.

  2. Bacteriological eradication.

    Proportion of patients bacteriologically cured, defined as less than 1,000 colony forming units (cfu)/ml.

    Measured: Day 14.

Secondary outcomes (6)
  1. Duration of symptoms.

    Number of days until the last day the patient scores 0 in any of the four symptoms.

    Measured: From baseline visit to day 7.

  2. Bacteriological eradication.

    Proportion of patients bacteriologically cured, defined as less than 1,000 cfu/ml.

    Measured: Day 28.

  3. Relapse rate.

    Proportion of patients presenting a relapse of symptoms within the first four weeks after inclusion in the study and timing of relapse of symptoms and/or bacteriuria.

    Measured: Days 7, 14 and 28.

  4. Reattendance and complication rate.

    Proportion of patients re-attending healthcare services and development of complications within the first 4 weeks (i.e. pyelonephritis, urosepsis).

    Measured: Days 7, 14 and 28.

  5. Adverse event rate.

    Proportion of patients presenting adverse and serious adverse events.

    Measured: Days 7, 14 and 28.

  6. Change in quality of life.

    Change in the quality of life by means of the 5-level EQ-5D version (EQ-5D-5L) validated questionnaire (Spanish version).

    Measured: Days 0 and 7.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jul 2021
  2. Study start2 Nov 2021
  3. Primary completion14 Dec 2024
  4. Study completion31 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
3 short-course antibiotic regimens and one-dose of fosfomycin
Masking
None (open label)
Enrolment
1,000 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04959331
Sponsor's protocol ID
IJG-SCOUT-2021
Acronym
SCOUT
Status last verified
Feb 2025
First submitted
5 Jul 2021
Last updated
8 Sep 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: On request

Publications

  • Llor C, Monfa R, Garcia-Sangenis A, Leiva A, Marin-Canada J, Sanchez-Calavera MA, Moragas A, Aguilar-Sanchez M, Troncoso-Marino A, Rodriguez-Barrientos R, Molero JM, Ouchi D, Miranda-Jimenez C, Fernandez-Garcia S, Morros R. Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial. Lancet. 2026 Apr 25;407(10539):1603-1613. doi: 10.1016/S0140-6736(25)02171-3. Epub 2026 Apr 20.

    PubMed 42026010
  • Garcia-Sangenis A, Morros R, Aguilar-Sanchez M, Medina-Perucha L, Leiva A, Ripoll J, Martinez-Pecharroman M, Bartolome-Moreno CB, Magallon Botaya R, Marin-Canada J, Molero JM, Moragas A, Troncoso A, Monfa R, Llor C; SCOUT Study Group. Clinical effectiveness and bacteriological eradication of three different Short-COurse antibiotic regimens and single-dose fosfomycin for uncomplicated lower Urinary Tract infections in adult women (SCOUT study): study protocol for a randomised clinical trial. BMJ Open. 2021 Nov 25;11(11):e055898. doi: 10.1136/bmjopen-2021-055898.

    PubMed 34824124

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Fosfomycin Trometamol Salt, Nitrofurantoin and Pivmecillinam in people with Urinary Tract Infections, run by Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina at 33 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Sep 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Clinical effectiveness. (time frame: Day 7.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04959331, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2025.

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