The Use of Fosfomycin to Treat Urinary Tract Infections in Kidney Transplant Recipients

Reid, Gail; Grim, Shellee A.; Layden, Jennifer E.; Akkina, Sanjeev; Tang, Ignatius; Campara, Maya; Clark, Nina M.

doi:10.1097/tp.0b013e318298dd26

Cited by 17 publications

(25 citation statements)

References 9 publications

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“…In addition, a discordance between in vitro susceptibility to fosfomycin and microbiological effectiveness was observed in patients with P. aeruginosa (75% versus 38%) and CR K. pneumoniae UTIs (92% versus 46%) (230). Furthermore, in a small case series of kidney transplantation patients and children with vesicoureteral reflux disease, a high rate of recurrent infections was reported, mainly due to different or more susceptible bacteria than those for which fosfomycin was initially prescribed (231,232). More robust data from well-designed and adequately powered studies should become available in order to reach safer conclusions.…”

Section: Urinary Tract Infectionsmentioning

confidence: 99%

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: Urinary Tract Infectionsmentioning

confidence: 99%

Fosfomycin

et al. 2016

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“…Additionally, a retrospective study by Reid et al was conducted using patient data from 2010 to 2011. [19] They specifically looked at 14 cases of gram-negative UTIs in patients who had received a kidney transplant. [19] 57% of patients in their study were administered 3 doses of fosfomycin, whereas only 11.6% of our patients received 3 doses.…”

Section: Discussionmentioning

confidence: 99%

“…[19] They specifically looked at 14 cases of gram-negative UTIs in patients who had received a kidney transplant. [19] 57% of patients in their study were administered 3 doses of fosfomycin, whereas only 11.6% of our patients received 3 doses. [18] Their study defined recurrence as having a UTI with the same organism within 3 months of the initial diagnosis, whereas we defined clinical failure as infection with the same organism within 30 days of the original culture.…”

Section: Discussionmentioning

confidence: 99%

“…[18] Reid et al reported 54% of patients had recurrence of their UTI. [19] The difference in recurrence rates between the 3 studies is likely due to differences in sample size, UTI pathogens, inclusion population, definition of recurrence, and patient specific factors, such as immunosuppression and comorbid conditions. [19] At the UMHS, VRE susceptibilities are routinely tested, but ESBL susceptibilities are tested only upon request.…”

Section: Discussionmentioning

confidence: 99%

“…[19] The difference in recurrence rates between the 3 studies is likely due to differences in sample size, UTI pathogens, inclusion population, definition of recurrence, and patient specific factors, such as immunosuppression and comorbid conditions. [19] At the UMHS, VRE susceptibilities are routinely tested, but ESBL susceptibilities are tested only upon request. There are no official E. faecium breakpoints for fosfomycin, but E. faecalis fosfomycin breakpoints were used for both species at our institution.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Nagel

Washer²,

Kunapuli³

et al. 2015

Int Arch Med

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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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