Surgical Suppurating Infections and Surgical Abdominal Infections Treated with Fosfomycin

Gallardo, Alfredo Javier Moheno; Sáez, J.M.; Enríquez, Goya; Cobacho, A.R.; Torronteras, Rafael; Recordan, C.; Moral, A; Arroyo, A.; Curiel, Arturo

doi:10.1159/000222080

Cited by 5 publications

(11 citation statements)

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“…Oral fosfomycin was administered as a single time dose for the treatment of UTI. There were also several studies of parenteral [ 18 , 24 , 26 – 28 ] and oral [ 28 , 59 , 60 ] fosfomycin that included children that did not present safety data in children separately. Four pediatric trials were comparative [ 11 , 44 , 49 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

Adverse Events Associated with Fosfomycin Use: Review of the Literature and Analyses of the FDA Adverse Event Reporting System Database

et al. 2015

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IntroductionThe growing problem of antibacterial resistance resulted in an increased interest in fosfomycin, especially its parenteral formulation. We reviewed fosfomycin safety profile using the Food and Drug Administration Adverse Event (AE) Reporting System (FAERS) and published literature.MethodsWe conducted a FAERS search and disproportionality analysis of all fosfomycin-associated AEs. We also conducted a FAERS search for AEs implicating fosfomycin as the primary suspect and a search of reports of fosfomycin-associated bone marrow toxicity. We then review the literature for publications reporting AEs associated with fosfomycin by conducting PubMed searches.ResultsThe disproportionality analysis of all FAERS reports of fosfomycin-associated AEs produced a higher than expected frequency of agranulocytosis, liver injury, severe skin reactions, and pseudomembranous colitis. Subsequent search for AEs where fosfomycin was the primary suspect and the literature review did not suggest a higher association of fosfomycin with these AEs. The search of bone marrow toxicity reports did not demonstrate an association between aplastic anemia and fosfomycin. The literature review selected 23 trials of parenteral administration of fosfomycin in 1242 patients including 8 comparative and 15 non-comparative trials. For oral fosfomycin, only prospective comparative trials (n = 28) in 2743 patients were included. The most frequent AEs associated with parenteral fosfomycin included rash, peripheral phlebitis, hypokalemia, and gastrointestinal disorders. Serious AEs such as aplastic anemia, anaphylaxis, and liver toxicities were reported infrequently. Gastrointestinal disorders were the most common AEs associated with oral fosfomycin.ConclusionThe identified AEs were consistent with the safety profile of fosfomycin. No new safety signals related to either parenteral or oral fosfomycin were identified.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0092-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Adverse Events Associated with Fosfomycin Use: Review of the Literature and Analyses of the FDA Adverse Event Reporting System Database

et al. 2015

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“…An antibiotic which might be particularly favorable in this regard is fosfomycin (6,8). To date, fosfomycin is considered a broad-spectrum antibiotic with a wide therapeutic range and is established as therapy for uncomplicated lower urinary tract infections (21).…”

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confidence: 99%

Distribution and Antimicrobial Activity of Fosfomycin in the Interstitial Fluid of Human Soft Tissues

Frossard

Joukhadar

Erovic

et al. 2000

Antimicrob Agents Chemother

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Fosfomycin is a broad-spectrum antibiotic which is established as therapy for uncomplicated lower urinary tract infections. In addition, preliminary data indicate that fosfomycin has a potential role in the treatment of soft tissue infections. However, the use of fosfomycin has not been established for this condition, and it is unclear whether the level of fosfomycin penetration into human soft tissues is high enough to eradicate relevant pathogens. To better characterize the antibiotic potential of fosfomycin, we applied a combined in vivo pharmacokinetic-in vitro pharmacodynamic model to human volunteers. In corresponding in vitro simulation experiments with selected isolates of Staphylococcus aureus, Enterobacter cloacae, and Serratia marcescens for which MICs were 16 g/ml, organisms were undetectable after a single dosing interval. Fosfomycin exhibits a strong ability to penetrate into the fluid of the interstitial space of soft tissues and reaches levels sufficient to substantially inhibit the growth of relevant bacteria at the target site. We therefore conclude that fosfomycin might qualify as an alternative candidate for the therapy of soft tissue infections.

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“…1. Finally, 15 unique studies [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] were included in this systematic review as five reports had overlapping populations with the included studies [31][32][33][34][35].…”

Section: Resultsmentioning

confidence: 99%

“…The characteristic of the included studies is depicted in ▶table 1. The majority of the included studies were RCTs [16,[20][21][22][23][24][26][27][28], three studies were retrospective cohort studies [19,29,30],…”

Section: Resultsmentioning

confidence: 99%

“…Almost half of the studies were carried out in Scandinavia with four from Sweden [21,23,24,26] and three from Denmark [16,18,22], respectively. The remaining studies were from Italy [27][28][29], Japan [19,20], Germany [17,25], and Spain [30]. The included studies reported on a median (range) of 58 (12-517) patients each, totalling 1,029 patients receiving fosfomycin in connection with gastrointestinal surgery (▶ table 1).…”

Section: Authorsmentioning

confidence: 99%

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Parenteral Fosfomycin in Gastrointestinal Surgery: A Systematic Review

Fonnes,

Holzknecht

et al. 2023

Drug Res (Stuttg)

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Background To investigate if perioperative parenteral administration of fosfomycin given before or during gastrointestinal surgery could protect against postoperative infectious complications and characterise the administration of fosfomycin and its harms. Methods This systematic review included original studies on gastrointestinal surgery where parental administration of fosfomycin was given before or during surgery to≥5 patients. We searched three databases on March 24 2023 and registered the protocol before data extraction (CRD42020201268). Risk of bias was assessed with Cochrane Handbook risk of bias assessment tool or the Newcastle-Ottawa Scale. A narrative description was undertaken. For infectious complications, results from emergency and elective surgery were presented separately. Results We included 15 unique studies, reporting on 1,029 patients that received fosfomycin before or during gastrointestinal surgery. Almost half of the studies were conducted in the 1980s to early 1990s, and typically a dose of 4 g fosfomycin was given before surgery co-administered with metronidazole and often repeated postoperatively. The risk of bias across studies was moderate to high. The rates of infectious complications were low after fosfomycin; the surgical site infection rate was 0–1% in emergency surgery and 0–10% in elective surgery. If reported, harms were few and mild and typically related to the gastrointestinal system. Conclusion There were few postoperative infectious complications after perioperative parenteral administration of one or more doses of 4 g fosfomycin supplemented with metronidazole in various gastrointestinal procedures. Fosfomycin was associated with few and mild harms.

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Surgical Suppurating Infections and Surgical Abdominal Infections Treated with Fosfomycin

Cited by 5 publications

References 0 publications

Adverse Events Associated with Fosfomycin Use: Review of the Literature and Analyses of the FDA Adverse Event Reporting System Database

Adverse Events Associated with Fosfomycin Use: Review of the Literature and Analyses of the FDA Adverse Event Reporting System Database

Distribution and Antimicrobial Activity of Fosfomycin in the Interstitial Fluid of Human Soft Tissues

Parenteral Fosfomycin in Gastrointestinal Surgery: A Systematic Review

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