In vitro fosfomycin activity in vancomycin-resistant Enterococcus faecalis

Superti, Silvana; Dias, Cícero Armídio Gomes; d’Azevedo, Pedro Alves

doi:10.1590/s1413-86702009000200010

“…[3,[6][7][8][9][10][11][12][13][16][17][18]In addition, this is the first study to compare clinical outcomes of fosfomycin in the hospital setting for MDR UTIs and associated antibiotic costs. Neuner et al conducted a retrospective chart review of 41 patients treated with fosfomcycin who had a MDR UTI from 2006 to 2010 but did not compare outcomes to other antibiotics traditionally prescribed for these pathogens.…”

Section: Discussionmentioning

confidence: 99%

“…[2,4] Thus, there is a need for less expensive and effective alternative antibiotics for the treatment of VRE and ESBL UTIs. [5][6][7][8][9] Fosfomycin tromethamine is a synthetic, broad spectrum, bactericidal antibiotic that works by inhibiting pyruvyl transferase during bacterial cell wall synthesis, and it may also decreases bacterial adherence to epithelial cells in the urinary tract. [10] Fosfomycin is available as an orally administered single-dose 3 gram sachet that is mixed with water.…”

Section: Introductionmentioning

confidence: 99%

“…[11] Fosfomycin has demonstrated efficacy in both in vitro and in vivo studies for treating UTIs caused by ESBL-producing Enterobacteriaceae, [12][13][14][15] while in vitro studies have shown high susceptibility of VRE to fosfomycin with susceptibilities of 98%. [5][6][7] Clinical data are limited to bolster the use of fosfomycin; however, a recent study showed high microbiological cure rates and in vitro susceptibility of VRE and ESBL UTI isolates to fosfomycin. [16] In 2010, the University of Michigan Health System (UMHS) Antimicrobial Stewardship Program introduced a guideline recommending the use of fosfomycin tromethamine for the treatment of lower UTIs caused by VRE or ESBL producing organisms that are resistant to other oral antibiotics.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Efficacy of Fosfomycin for the Treatment of Complicated Lower Tract and Uncomplicated Urinary Tract Infections

Nagel

¹

,

Washer²,

Kunapuli³

et al. 2015

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Fosfomycin is an oral antibiotic with activity against multidrug resistant organisms, including vancomycin-resistant enterococcus (VRE) and extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae. However, there is currently no information describing efficacy of fosfomycin compared to other agents for healthcare associated UTIs. Additionally, there is minimal information characterizing the potential cost savings with utilization of fosfomcyin versus traditional therapies. This retrospective study evaluated clinical and economic outcomes of fosfomycin compared to matched controls. The controls were before the addition of fosfomycin to hospital formulary with recommended prescribing criteria. The fosfomycin group consisted of patients who were admitted to the hospital after the addition of fosfomycin to the hospital formulary with recommended prescribing criteria. Patients receiving fosfomycin for the treatment of UTI were matched to control patients based on pathogen, renal function, and presence of a lower UTI. A total of 86 patients were evaluated. The majority of patients received fosfomycin for the treatment of VRE (45.6%) and ESBL producing Enterbacteriaceae (16.3%) UTIs. Patients with a combination of allergies or documented resistance to first line agents also received fosfomycin to treat Enterococcus (25.6%), Enterobacteriaceae (7.8%), or polymicrobial UTIs (4.7%). Doxycycline, nitrofurantoin, sulfamethoxazole/trimethoprim, meropenem, and linezolid were the most common antibiotics prescribed in the control group. The average days of treatment were lower in the fosfomycin group (2.93 vs. 7.19 days, p<0.0001). Fosfomcyin was associated with similar clinical success rates (95 vs. 95%, p>0.99) and recurrence rates (4.7 vs. 4.7%, p>0.99).

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“…However, resistance to these agents was reported. 7,14 In this study, we determined that all VR E. faecium isolates were susceptible to fosfomycin. Allerger et al 15 reported that 96% of VRE were susceptible to fosfomycin according to the disc diffusion method.…”

Section: 13mentioning

confidence: 99%

In vitro efficacy of fosfomycin against clinical strains

Karadağ¹,

Çaycı²,

Bılgın³

et al. 2015

Journal of Microbiology and Infectious Diseases

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Objective: Fosfomycin is an alternative drug for treatment of uncomplicated urinary tract infections. This study aimed to investigate in vitro activity of fosfomycin against methicillin-resistant Staphylococcus aureus (MRSA), methicillinresistant coagulase negative staphylococci (MRCoNS), vancomycin-resistant Enterococcus faecium (VR E. faecium), Escherichia coli, Klebsiella pneumoniae, and Enterobacter isolates. Methods:Clinical isolates of MRSA, MRCoNS, E. coli, K. pneumoniae and Enterobacter spp. and VRE isolates which were isolated from rectal swaps were identified with Vitek 2 Compact (Biomeriux, France) and BD Phoenix (BD USA) automated systems. The Kirby-Bauer disc diffusion method was used to determine the susceptibility to fosfomycin.Results: All the MRSA (n=40), MRCoNS (n=40), and VR E. faecium (n=62) isolates were susceptible to fosfomycin. The fosfomycin susceptibility rates for E. coli, K. pneumoniae, and Enterobacter spp. were 97.5% (39 of 40), 97.3% (36 of 37), and 86.9% (20 of 23), respectively. One (2.7%) isolate of K. pneumoniae and three (13.1%) isolates of Enterobacter spp. showed intermediate susceptibility to fosfomycin. Resistance to fosfomycin was detected in only one (2.5%) isolate of E. coli. Conclusion:Based on the results of our study, fosfomycin is highly active against a collection of several gram-positive and gram-negative bacteria, including multidrug resistant isolates, and is an alternative drug in the treatment option.

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“…Glycopeptide resistance has become a significant problem in nosocomial infections. 7 S. aureus is an important cause of nosocomial bacteremia. Coagulase-negative staphylococci are one of the most common sources of blood-and catheter-associated infections, particularly in hematology and oncology patients.…”

Section: Introductionmentioning

confidence: 99%

In vitro efficacy of fosfomycin against clinical strains

Karadağ¹

2014

Jmid

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Objective: Fosfomycin is an alternative drug for treatment of uncomplicated urinary tract infections. This study aimed to investigate in vitro activity of fosfomycin against methicillin-resistant Staphylococcus aureus (MRSA), methicillinresistant coagulase negative staphylococci (MRCoNS), vancomycin-resistant Enterococcus faecium (VR E. faecium), Escherichia coli, Klebsiella pneumoniae, and Enterobacter isolates. Methods:Clinical isolates of MRSA, MRCoNS, E. coli, K. pneumoniae and Enterobacter spp. and VRE isolates which were isolated from rectal swaps were identified with Vitek 2 Compact (Biomeriux, France) and BD Phoenix (BD USA) automated systems. The Kirby-Bauer disc diffusion method was used to determine the susceptibility to fosfomycin.Results: All the MRSA (n=40), MRCoNS (n=40), and VR E. faecium (n=62) isolates were susceptible to fosfomycin. The fosfomycin susceptibility rates for E. coli, K. pneumoniae, and Enterobacter spp. were 97.5% (39 of 40), 97.3% (36 of 37), and 86.9% (20 of 23), respectively. One (2.7%) isolate of K. pneumoniae and three (13.1%) isolates of Enterobacter spp. showed intermediate susceptibility to fosfomycin. Resistance to fosfomycin was detected in only one (2.5%) isolate of E. coli. Conclusion:Based on the results of our study, fosfomycin is highly active against a collection of several gram-positive and gram-negative bacteria, including multidrug resistant isolates, and is an alternative drug in the treatment option.

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In vitro fosfomycin activity in vancomycin-resistant Enterococcus faecalis

Cited by 10 publications

References 12 publications

Clinical Efficacy of Fosfomycin for the Treatment of Complicated Lower Tract and Uncomplicated Urinary Tract Infections

Clinical Efficacy of Fosfomycin for the Treatment of Complicated Lower Tract and Uncomplicated Urinary Tract Infections

In vitro efficacy of fosfomycin against clinical strains

In vitro efficacy of fosfomycin against clinical strains

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