Bacteriological Evaluation of Fosfomycin in Clinical Studies

Abstract

Since fosfomycin has behaved in vitro as a broad-spectrum antibiotic, an attempt has been made to evaluate this behaviour in controlled clinical study carried out at different Spanish hospitals. A total of 959 patients were treated for some of the following infectious clinical processes: gonococcal urethritis, typhoid fever, enterocolitis, acute and chronic urinary tract infections, osteomyelitis, chronic otorrhoea, septicaemia, meningitis, peritonitis, surgical and suppurative infections, bronchitis, pneumonia, pharyngoamygdalitis, burns, endometritis, ocular infection, whooping cough and nasal carriers of S. aureus. The results obtained as a function of the microorganism isolated in these clinical processes in percentage of clinical and bacteriological success have been 96% of the S. aureus infections, 95% of the Streptococcus sp. including S. pneumoniae, 90% of the N. gonorrhoeae infections, 94% of the E. coli infections including enteropatho-genic E. coli, 90% of the S. marcescens infections, 76% of the Proteus sp. infections, 72% of the Klebsiella-Enterobacter infections, 66% of P. aeruginosa infections and 78% of the S. typhi infections.

In vitro activity of fosfomycin, alone and in combination, against methicillin-resistant Staphylococcus aureus

“…Its activity in vitro alone and in combination with betalactam antibiotics such as cefamandole and methicillin correlated well with in vivo results reported in Europe (10,11). Our study suggests that fosfomycin alone, or in combination with beta-lactam antimicrobial agents, has activity against methicillin-resistant S. aiurelis strains, but further animal and clinical studies are necessary to confirm these results.…”

Clinical Appraisal of Fosfomycin in the Era of Antimicrobial Resistance

“…In addition, the single-arm study design precluded comparisons of efficacies. However, given the very high clinical success rates of 75 to 90% with fosfomycin, which were comparable to the historic clinical success rates for antimicrobial treatment of UTIs (20,25), the additional value of having a comparator arm would have been modest. We also limited our analysis to inpatients, since the general lack of follow-up data made it difficult to study outpatients retrospectively; this would require a prospective approach.…”

In vitro activities of teichomycin, fusidic acid, flucloxacillin, fosfomycin, and vancomycin against methicillin-resistant Staphylococcus aureus

“…It has a half-life of 2 h (10). Due to poor absorption, 1 g given orally results in a peak level of 5.3 ,ug/ml in serum, whereas the intramuscular route yields levels of 25 to 30 jig/ml (6,12,17). Our in vitro studies revealed it to be active against oUr strains of MRSA, with 50 and 90% MICs of 1.2 and 5.0 p.g/ml, respectively.…”