Penetration of Fosfomycin into Inflammatory Lesions in Patients with Cellulitis or Diabetic Foot Syndrome

Legat, Franz J.; Maier, Andrea B.; Dittrich, P.; Zenahlik, P.; Kern, Timothy S.; Nuhsbaumer, Stephan; Frossard, Martin; Salmhofer, Wolfgang; Kerl, Helmut; Müller, Markus

doi:10.1128/aac.47.1.371-374.2003

Cited by 62 publications

(35 citation statements)

References 15 publications

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“…Similar findings were reported for diabetic foot infections with osteomyelitis (184). Fosfomycin also exhibited similar penetration into subcutaneous tissue regardless of the presence of inflammation (185). However, fosfomycin levels in the abscess fluid were highly variable.…”

Section: Parenteral Fosfomycin Disodiumsupporting

confidence: 70%

Fosfomycin

et al. 2016

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SUMMARYThe treatment of bacterial infections suffers from two major problems: spread of multidrug-resistant (MDR) or extensively drug-resistant (XDR) pathogens and lack of development of new antibiotics active against such MDR and XDR bacteria. As a result, physicians have turned to older antibiotics, such as polymyxins, tetracyclines, and aminoglycosides. Lately, due to development of resistance to these agents, fosfomycin has gained attention, as it has remained active against both Gram-positive and Gram-negative MDR and XDR bacteria. New data of higher quality have become available, and several issues were clarified further. In this review, we summarize the available fosfomycin data regarding pharmacokinetic and pharmacodynamic properties, thein vitroactivity against susceptible and antibiotic-resistant bacteria, mechanisms of resistance and development of resistance during treatment, synergy and antagonism with other antibiotics, clinical effectiveness, and adverse events. Issues that need to be studied further are also discussed.

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Section: Parenteral Fosfomycin Disodiumsupporting

confidence: 70%

Fosfomycin

et al. 2016

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“…50% and 70%, respectively, of the corresponding serum values [28]. Similar findings have been observed A c c e p t e d M a n u s c r i p t in additional studies evaluating the degree of penetration of fosfomycin into soft tissue in patients with sepsis, cellulitis or diabetic foot infections [30,31,60].…”

Section: Soft Tissue Infectionssupporting

confidence: 69%

“…Several studies have evaluated the degree of penetration of fosfomycin into soft tissue (muscle or subcutaneous tissue) [28,30,31,60]. Briefly, i.v.…”

Section: Soft Tissue Infectionsmentioning

confidence: 99%

Clinical significance of the pharmacokinetic and pharmacodynamic characteristics of fosfomycin for the treatment of patients with systemic infections

Roussos

Karageorgopoulos

Samonis

et al. 2009

International Journal of Antimicrobial Agents

158

151

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“…Fosfomycin penetrates excellently into various tissues (9,14,18,21) and cerebrospinal fluid (14,27) and is frequently administered in combination with other antimicrobial agents in Europe to combat severe bacterial infections. It exerts bactericidal activity under anaerobic conditions (17), such as is the case within encapsulated purulent lesions, and has a negligible protein binding.…”

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confidence: 99%

Antibiotic Abscess Penetration: Fosfomycin Levels Measured in Pus and Simulated Concentration-Time Profiles

Sauermann

Karch²,

Langenberger³

et al. 2005

Antimicrob Agents Chemother

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The present study was performed to evaluate the ability of fosfomycin, a broad-spectrum antibiotic, to penetrate into abscess fluid. Twelve patients scheduled for surgical or computer tomography-guided abscess drainage received a single intravenous dose of 8 g of fosfomycin. The fosfomycin concentrations in plasma over time and in pus upon drainage were determined. A pharmacokinetic model was developed to estimate the concentration-time profile of fosfomycin in pus. Individual fosfomycin concentrations in abscess fluid at drainage varied substantially, ranging from below the limit of detection up to 168 mg/liter. The fosfomycin concentrations in pus of the study population correlated neither with plasma levels nor with the individual ratios of abscess surface area to volume. This finding was attributed to highly variable abscess permeability. The average concentration in pus was calculated to be 182 ؎ 64 mg/liter at steady state, exceeding the MIC 50/90 s of several bacterial species which are commonly involved in abscess formation, such as streptococci, staphylococci, and Escherichia coli. Hereby, the exceptionally long mean half-life of fosfomycin of 32 ؎ 39 h in abscess fluid may favor its antimicrobial effect because fosfomycin exerts time-dependent killing. After an initial loading dose of 10 to 12 g, fosfomycin should be administered at doses of 8 g three times per day to reach sufficient concentrations in abscess fluid and plasma. Applying this dosing regimen, fosfomycin levels in abscess fluid are expected to be effective after multiple doses in most patients.

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Penetration of Fosfomycin into Inflammatory Lesions in Patients with Cellulitis or Diabetic Foot Syndrome

Cited by 62 publications

References 15 publications

Fosfomycin

Fosfomycin

Clinical significance of the pharmacokinetic and pharmacodynamic characteristics of fosfomycin for the treatment of patients with systemic infections

Antibiotic Abscess Penetration: Fosfomycin Levels Measured in Pus and Simulated Concentration-Time Profiles

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