PMID- 22926565
OWN - NLM
STAT- MEDLINE
DCOM- 20130423
LR  - 20220409
IS  - 1098-6596 (Electronic)
IS  - 0066-4804 (Print)
IS  - 0066-4804 (Linking)
VI  - 56
IP  - 11
DP  - 2012 Nov
TI  - Experience with fosfomycin for treatment of urinary tract infections due to 
      multidrug-resistant organisms.
PG  - 5744-8
LID - 10.1128/AAC.00402-12 [doi]
AB  - Fosfomycin has shown promising in vitro activity against multidrug-resistant 
      (MDR) urinary pathogens; however, clinical data are lacking. We conducted a 
      retrospective chart review to describe the microbiological and clinical outcomes 
      of urinary tract infections (UTIs) with MDR pathogens treated with fosfomycin 
      tromethamine. Charts for 41 hospitalized patients with a urine culture for an MDR 
      pathogen who received fosfomycin tromethamine from 2006 to 2010 were reviewed. 
      Forty-one patients had 44 urinary pathogens, including 13 carbapenem-resistant 
      Klebsiella pneumoniae (CR-Kp), 8 Pseudomonas aeruginosa, and 7 
      vancomycin-resistant Enterococcus faecium (VRE) isolates, 7 extended-spectrum 
      beta-lactamase (ESBL) producers, and 9 others. In vitro fosfomycin susceptibility 
      was 86% (median MIC, 16 mug/ml; range, 0.25 to 1,024 mug/ml). Patients received an 
      average of 2.9 fosfomycin doses per treatment course. The overall microbiological 
      cure was 59%; failure was due to either relapse (24%) or reinfection UTI (17%). 
      Microbiological cure rates by pathogen were 46% for CR-Kp, 38% for P. aeruginosa, 
      71% for VRE, 57% for ESBL producers, and 100% for others. Microbiological cure (n 
      = 24) was compared to microbiological failure (n = 17). There were significantly 
      more solid organ transplant recipients in the microbiological failure group (59% 
      versus 21%; P = 0.02). None of the patients in the microbiological cure group had 
      a ureteral stent, compared to 24% of patients within the microbiological failure 
      group (P = 0.02). Fosfomycin demonstrated in vitro activity against UTIs due to 
      MDR pathogens. For CR-KP, there was a divergence between in vitro susceptibility 
      (92%) and microbiological cure (46%). Multiple confounding factors may have 
      contributed to microbiological failures, and further data regarding the use of 
      fosfomycin for UTIs due to MDR pathogens are needed.
FAU - Neuner, Elizabeth A
AU  - Neuner EA
AD  - Department of Pharmacy, Cleveland Clinic, Cleveland, Ohio, USA. neunere@ccf.org
FAU - Sekeres, Jennifer
AU  - Sekeres J
FAU - Hall, Gerri S
AU  - Hall GS
FAU - van Duin, David
AU  - van Duin D
LA  - eng
PT  - Journal Article
DEP - 20120827
PL  - United States
TA  - Antimicrob Agents Chemother
JT  - Antimicrobial agents and chemotherapy
JID - 0315061
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Carbapenems)
RN  - 2N81MY12TE (Fosfomycin)
RN  - EC 3.5.2.6 (beta-Lactamases)
SB  - IM
MH  - Aged
MH  - Anti-Bacterial Agents/pharmacology/*therapeutic use
MH  - Carbapenems/pharmacology/therapeutic use
MH  - *Drug Resistance, Multiple, Bacterial
MH  - Enterococcus faecium/*drug effects/growth & development
MH  - Female
MH  - Fosfomycin/pharmacology/*therapeutic use
MH  - Humans
MH  - Klebsiella pneumoniae/*drug effects/growth & development
MH  - Male
MH  - Microbial Sensitivity Tests
MH  - Middle Aged
MH  - Pseudomonas aeruginosa/*drug effects/growth & development
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Urinary Tract Infections/*drug therapy/microbiology
MH  - beta-Lactamases/metabolism
PMC - PMC3486602
EDAT- 2012/08/29 06:00
MHDA- 2013/04/24 06:00
PMCR- 2013/05/01
CRDT- 2012/08/29 06:00
PHST- 2012/08/29 06:00 [entrez]
PHST- 2012/08/29 06:00 [pubmed]
PHST- 2013/04/24 06:00 [medline]
PHST- 2013/05/01 00:00 [pmc-release]
AID - AAC.00402-12 [pii]
AID - 00402-12 [pii]
AID - 10.1128/AAC.00402-12 [doi]
PST - ppublish
SO  - Antimicrob Agents Chemother. 2012 Nov;56(11):5744-8. doi: 10.1128/AAC.00402-12. 
      Epub 2012 Aug 27.