Randomized, Multicenter, Non-inferiority Trial Comparing the Efficacy of Fosfomycin Versus Fluoroquinolones or Cotrimoxazole as Oral Follow-up Treatment in Febrile Urinary Tract Infections in Men Caused by Susceptible Enterobacteria (FOSFORMEN)

Inclusion Criteria:

• Male
• Age ≥ 18
• Body temperature ≥ 38°C within the 72 hours preceding the diagnosis of UTI
• At least one of the following symptoms : dysuria, higher urinary frequency, urgency, hematuria, suprapubic pain, prostatic pain, or perineal pain
• Positive urine microbiological examination (urine culture) : Sample collected before initiation of the empiric antibiotic therapy, ≥ 10 leukocytes/µL, and monomicrobial culture positive for E. coli with bacteriuria ≥ 103 CFU/mL
• The strain must be suceptible to fosfomycin and to either FQ or TMP-SMX according to EUCAST
• The strain must be suceptible to the empiric antibiotic therapy received
• Ability to take oral treatment
• Favorable clinical evolution after receiving effective empiric antibiotic therapy for 72 ± 24 hours ; Favorable evolution is defined as body temperature < 38°C with clinical improvement or resolution of the clinical signs and symptoms of urinary tract infection present at diagnosis, including the absence or improvement of dysuria, pollakiuria, urinary urgency, hematuria, suprapubic, prostatic, or perineal pain, urethral pain during urination, and/or a burning sensation during urination.

Exclusion Criteria:

• Presence of another condition that could explain the fever
• Septic shock of urinary origin
• Need for a urological procedure
• Anatomical abnormalities of the urinary tract (e.g., urinary prostheses and implants [except JJ], Bricker, neobladder, total prostatectomy, uretrestomy, nephrostomy, urinary fistula)
• Presence of an indwelling urinary catheter, except of placed during the current UTI episode
• Neurogenic bladder
• Immunosupression
• Contraindication to the use of FQ , TMP-SMX or FT
• Severe chronic kidney disease with an estimated flomerular filtration rate < 20 mL/min
• UTI treated within the past 3 months
• High probability of death within 3 months
• Major cognitive disorders
• Patients deprived of their liberty by judicial or administrative decision, under guardianship or curatorship
• Lack of social security coverage
• Absence of written informed consent
• Participation in another interventional research protocol
• Absence of written informed consent
• Participation in another interventional research protocol
• Patients deprived of their liberty by a judicial or administrative decision