Evaluation of the in vitro activity of fosfomycin tromethamine against Gram-negative bacterial strains recovered from community- and hospital-acquired urinary tract infections in Turkey

Demir, Tülin; Buyukguclu, Tuncay

doi:10.1016/j.ijid.2013.04.005

Cited by 55 publications

(59 citation statements)

References 31 publications

(69 reference statements)

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“…Our findings for the fosfomycin MIC against E. coli and Klebsiella spp. were consistent with those reported in recent studies that evaluated in vitro susceptibility profiles (1,19,20). Fosfomycin presented high levels of activity against E. coli.…”

Section: Discussionsupporting

confidence: 92%

“…rinary tract infections (UTIs) are the most common infections worldwide, and members of the family Enterobacteriaceae are the main pathogens responsible for UTIs (1). The rise in the rate of antibiotic resistance over the last several years has resulted in limited treatment options currently available for the treatment of infections caused by multidrug-resistant (MDR) bacteria.…”

mentioning

confidence: 99%

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Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Fedrigo

Mazucheli

Albiero

et al. 2017

Antimicrob Agents Chemother

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Fosfomycin is widely used for the treatment of uncomplicated urinary tract infection (UTI), and it has recently been recommended that fosfomycin be used to treat infections caused by multidrug-resistant (MDR) Gram-negative bacilli. Whether urine acidification can improve bacterial susceptibility to fosfomycin oral dosing regimens has not been analyzed. The MIC of fosfomycin for 245 Gramnegative bacterial isolates, consisting of 158 Escherichia coli isolates and 87 Klebsiella isolates which were collected from patients with urinary tract infections, were determined at pH 6.0 and 7.0 using the agar dilution method. Monte Carlo simulation of the urinary fosfomycin area under the concentration-time curve (AUC) after a single oral dose of 3,000 mg fosfomycin and the MIC distribution were used to determine the probability of target attainment (PTA). Fosfomycin was effective against E. coli (MIC 90 Յ 16 g/ml) but not against Klebsiella spp. (MIC 90 Ͼ 512 g/ml). Acidification of the environment increased the susceptibility of 71% of the bacterial isolates and resulted in a statistically significant decrease in bacterial survival. The use of a regimen consisting of a single oral dose of fosfomycin against an E. coli isolate with an MIC of Յ64 mg/liter was able to achieve a PTA of Ն90% for a target pharmacodynamic index (AUC/MIC) of 23 in urine; PTA was not achieved when the MIC was higher than 64 mg/liter. The cumulative fractions of the bacterial responses (CFR) were 99% and 55% against E. coli and Klebsiella spp., respectively, based on simulated drug exposure in urine with an acidic pH of 6.0. A decrease of the pH from 7.0 to 6.0 improved the PTA and CFR of the target pharmacodynamic index in both E. coli and Klebsiella isolates.KEYWORDS Enterobacteriaceae, fosfomycin, Monte Carlo simulation, acidic pH, pharmacodynamics, urinary tract infection U rinary tract infections (UTIs) are the most common infections worldwide, and members of the family Enterobacteriaceae are the main pathogens responsible for UTIs (1). The rise in the rate of antibiotic resistance over the last several years has resulted in limited treatment options currently available for the treatment of infections caused by multidrug-resistant (MDR) bacteria. Fosfomycin is an old antibiotic agent frequently used to treat uncomplicated UTIs and has been reevaluated as a potential option for the treatment of infections caused by MDR Gram-negative bacteria (2). The dosage currently approved for the treatment of an uncomplicated UTI is a single

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Fedrigo

Mazucheli

Albiero

et al. 2017

Antimicrob Agents Chemother

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“…In our study, the ESBL production rates were 13.3% and 18.7% for E. coli and Klebsiella spp., respectively. The studies reporting ESBL production rates in our country showed similar results (15,16). Despite the common increasing in ESBL production in both of in and outpatients, this rates can vary among both regions and hospitals.…”

Section: Discussionsupporting

confidence: 74%

“…In 2012, the overall prevalence in our study among inpatients and outpatients was 44.7% and 22.8%, respectively. The lower rates were reported in outpatients from Turkey (16,17,20). Although in Netherlands, the prevalence of ESBL-producing E. coli in outpatients is lower than our country, there was a significant increasing from 2004 (0.1%) to 2009 (1%) (18).…”

Section: Escherichia Colicontrasting

confidence: 54%

Antibiotic Resistance Trends and The ESBL Prevalence of Escherichia coli and Klebsiella spp Urinary Isolates in In-and Outpatients in a Tertiary Care Hospital in Istanbul, 2004 - 2012

Şenbayrak

Boz

Cevan³

et al. 2017

Jundishapur J Microbiol

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“…Fosfomycin is a cell wallactive antimicrobial agent found to be effective against E. coli, Citrobacter spp, Enterobacter spp, Klebsiella spp, Serratia spp, and Enterococcus faecalis related UTIs [24][25][26][27]. Although it has been used for several years, resistance has remained low, at 0.3-2.8 % in E. coli and 7.2-28.6 % in Klebsiella spp [28]. According to our study, fosfomycin and nitrofurantoin showed higher activity against ESBL-EC isolates (94.9, 93.2 %, respectively) than ESBL-KP isolates(61.7, 19.6 %, respectively).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial susceptibilities of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin

et al. 2015

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Fosfomycin could be an alternative treatment option for UTIs related to ESBL-producing E. coli spp. and CoA-UTI, but not for UTIs related to ESBL-producing Klebsiella spp. Antimicrobial susceptibilities of ESBL-producing strains were different according to the UTI classification. Fosfomycin showed decreased activity against isolates from HCA-UTI and HA-UTI. However, further clinical verification is required to assess the clinical efficacy of fosfomycin for the treatment of UTIs caused by ESBL-producing E. coli isolates.

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Evaluation of the in vitro activity of fosfomycin tromethamine against Gram-negative bacterial strains recovered from community- and hospital-acquired urinary tract infections in Turkey

Cited by 55 publications

References 31 publications

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Pharmacodynamic Evaluation of Fosfomycin against Escherichia coli and Klebsiella spp. from Urinary Tract Infections and the Influence of pH on Fosfomycin Activities

Antibiotic Resistance Trends and The ESBL Prevalence of Escherichia coli and Klebsiella spp Urinary Isolates in In-and Outpatients in a Tertiary Care Hospital in Istanbul, 2004 - 2012

Antimicrobial susceptibilities of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in health care-associated urinary tract infection: focus on susceptibility to fosfomycin

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