Fosfomycin for the Treatment of Cystitis in the Abdominal Solid Organ Transplant Population

Loethen, Ashley A.; Kerstenetzky, Luiza; Descourouez, Jillian L.; Leverson, Glen; Smith, Jeannina A.; Jorgenson, Margaret R.

doi:10.1002/phar.1924

Cited by 7 publications

(4 citation statements)

References 11 publications

(46 reference statements)

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“…9 There is also minimal literature supporting the use of FOS in the SOT population. 4,[6][7][8]14 The studies that are available delineate treatment success in the setting of MDR pathogens but do not specifically address success in those patients with renal impairment. This analysis suggests that, overall, the use of FOS for treatment of cystitis in the SOT population appears to be successful, with cure rates >85%.…”

Section: Discussionmentioning

confidence: 99%

Fosfomycin tromethamine for the Treatment of Cystitis in Abdominal Solid Organ Transplant Recipients With Renal Dysfunction

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Fosfomycin tromethamine for the Treatment of Cystitis in Abdominal Solid Organ Transplant Recipients With Renal Dysfunction

et al. 2017

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“…Some studies have suggested that fosfomycin may play a role in the treatment of MDR bacteria including MDR Pseudomonas aeruginosa , extended‐spectrum β‐lactamase (ESBL)–producing Enterobacteriaceae , carbapenem‐resistant Klebsiella pneumoniae , vancomycin‐resistant Enterococcus faecium (VRE), and methicillin‐resistant Staphylococcus aureus . Nevertheless, and despite the above‐mentioned advantages, available experience on the usefulness and safety of oral fosfomycin for the treatment of symptomatic UTI (mainly in the form of cystitis) or asymptomatic bacteriuria (AB) among KTRs are based on single‐center series with a small number of cases and poor representation of MDR strains. Thus the aim of the study was to assess the efficacy and safety of oral fosfomycin for the treatment of lower UTI in a large contemporary multicenter cohort of KTRs in Spain.…”

Section: Introductionmentioning

confidence: 99%

Oral fosfomycin for the treatment of lower urinary tract infections among kidney transplant recipients—Results of a Spanish multicenter cohort

López‐Medrano

Silva

Fernández‐Ruiz

et al. 2020

American Journal of Transplantation

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Oral fosfomycin may constitute an alternative for the treatment of lower urinary tract infections (UTIs) in kidney transplant recipients (KTRs), particularly in view of recent safety concerns with fluroquinolones. Specific data on the efficacy and safety of fosfomycin in KTR are scarce. We performed a retrospective study in 14 Spanish hospitals including KTRs treated with oral fosfomycin (calcium and trometamol salts) for posttransplant cystitis between January 2005 and December 2017. A total of 133 KTRs developed 143 episodes of cystitis. Most episodes (131 [91.6%]) were produced by gram‐negative bacilli (GNB), and 78 (54.5%) were categorized as multidrug resistant (including extended‐spectrum β‐lactamase‐producing Enterobacteriaceae [14%] or carbapenem‐resistant GNB [3.5%]). A median daily dose of 1.5 g of fosfomycin (interquartile range [IQR]: 1.5‐2) was administered for a median of 7 days (IQR: 3‐10). Clinical cure (remission of UTI‐attributable symptoms at the end of therapy) was achieved in 83.9% (120/143) episodes. Among those episodes with follow‐up urine culture, microbiological cure at month 1 was achieved in 70.2% (59/84) episodes. Percutaneous nephrostomy was associated with a lower probability of clinical cure (adjusted odds ratio: 10.50; 95% confidence interval: 0.98‐112.29; P = 0.052). In conclusion, fosfomycin is an effective orally available alternative for treating cystitis among KTRs.

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“…Other studies found comparable clinical cure rates. [66][67][68] A more recent study found clinical and microbiological cure rates of 84% (120/143)) and 70% (59/84), respectively, although in these studies FT was used as first-line treatment (83.2%) instead of as salvage treatment in our study (66.0%) and for a longer duration (median 7 days vs. 1 day in our study). 69 Also within each study, variations in treatment duration and interval were large.…”

Section: Definitions Manifestations and Classificationscontrasting

confidence: 62%

“…[55][56][57] Structural problems in some countries, but sporadic challenges in the Netherlands, are the high incidence of colistin resistant Enterobacterales, further . 7,65,66 In some European countries, prevalence of CRE among K.pneumoniae is up to 60%, while this is only 0.2% in the Netherlands. 7,67 Some populations require frequent use of broad-spectrum antimicrobials, which facilitates selection of antibiotic-resistant bacteria and diminishes the arsenal of antibiotic options for UTI.…”

Section: Definitions Manifestations and Classificationsmentioning

confidence: 99%

Old means for new ends

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Treatment of cystitis in general practice Chapter 2 The effectiveness of nitrofurantoin, fosfomycin and trimethoprim for the treatment of cystitis in relation to renal function Letter to the editor Author's response Chapter 3 Effectiveness of extended-versus normal-release nitrofurantoin for cystitis: an instrumental variable analysis Chapter 4 Nitrofurantoin 50 mg versus 100 mg prophylaxis for urinary tract infections, a cohort study Urinary tract infections and antibiotic resistance among Gram-negative bacteria in the hospital Chapter 5 Carbapenem-alternative strategies for complicated urinary tract infections: a systematic review of randomized controlled trials Chapter 6 Fosfomycin Etest for Enterobacteriaceae: Interobserver and interlaboratory agreement Chapter 7 In vivo acquisition of fosfomycin resistance in Escherichia coli by fosA transmission from commensal flora Chapter 8 Fosfomycin-trometamol for Urinary Tract Infections in Kidney Transplant Recipients Chapter 9 Oral fosfomycin versus ciprofloxacin in women with E.coli febrile urinary tract infection, a protocol for a double-blind placebo-controlled randomized controlled non-inferiority trial (FORECAST) Chapter 10 Fosfomycin versus ciprofloxacin as oral stepdown treatment for Escherichia coli febrile urinary tract infection in women: a randomised, placebo-controlled, double blind, multicenter trial Chapter 11 The survival of highly resistant Enterobacterales in hospital admitted patients Chapter 12 General discussion Appendices Nederlandstalige samenvatting / Dutch summary List of publications Dankwoord / Acknowledgments About the author CHAPTER 1 GENERAL INTRODUCTION Old Means for New Ends 8 1 Old Means for New Ends 9 Enterococcus spp. or Group B Streptococcus regularly represent contamination. 18,19 A certain density of Candida spp. or Enterococcus spp. species could be considered uropathogenic in immunosuppressed hosts but contaminants in immunocompetent persons. 1,20 Contamination is defined variably in literature as a urine culture revealing lower colony counts, mixed bacteria, or skin flora. 21 The risk of contamination is lower if urine is collected and stored appropriately. Reference procedures for urine collection are by single catheterization or suprapubic aspiration, although these cannot be used structurally in routine care.Obtainment of midstream urine with cleansing is recommended for non-invasive routine testing, although the underlying evidence for cleansing is low. 22 Some methods to collect urine are accompanied with a high risk of contamination, e.g. urine collected from catheter bags or diapers. 19,23,24 In the classification of UTI, a distinction is made between cystitis (or lower-UTI) with inflammation of the urinary tract only and febrile UTI (or upper-UTI or UTI with systemic symptoms) with invasion of the prostate, pyelum and/or bloodstream, causing prostatitis, pyelonephritis and/or sepsis. 20 Cystitis is a common, benign yet burdensome disease that is mainly treated in general practice, while febrile UTI is a potentiall...

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Fosfomycin for the Treatment of Cystitis in the Abdominal Solid Organ Transplant Population

Abstract: FOS appears to be successful in the treatment of cystitis in aSOT recipients. Multidose therapy did not significantly improve success over a single-dose regimen. Further prospective studies are needed to elucidate the true efficacy of FOS in the aSOT population.

Cited by 7 publications

References 11 publications

Fosfomycin tromethamine for the Treatment of Cystitis in Abdominal Solid Organ Transplant Recipients With Renal Dysfunction

Fosfomycin tromethamine for the Treatment of Cystitis in Abdominal Solid Organ Transplant Recipients With Renal Dysfunction

Oral fosfomycin for the treatment of lower urinary tract infections among kidney transplant recipients—Results of a Spanish multicenter cohort

Old means for new ends

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