Enteropathogenic <i>E. coli</i> Gastroenterocolitis in Neonates Treated with Fosfomycin

Abstract

The effect of calcium salt of fosfomycin in the treatment of 43 neonates suffering from acute gastroenterocolitis produced by enteropathogenic E. coli is evaluated. The minimal inhibitory concentration of these E. coli was, generally, lower that 128 μg/ml. Dosages of 150–200 mg/kg body weight/day were administered orally every 8 h. This treatment lasted for 4 days only. Clinical evolution was favorable in 38 (88%) babies and bacteriological evolution in 30 (70%). In eight cases a different flora to the initial was selected during the treatment with fosfomycin. None of the cases treated showed any toxic alteration attributed to the antibiotic.

Reintroduction of Legacy Antibiotics in Neonatal Sepsis: The Special Role of Fosfomycin and Colistin

“…The neonates were treated with high doses of oral fosfomycin (150-200 mg/kg three times daily) for four days. Microbiological cure was achieved in 69.9% of the cases, and clinical symptoms subsided in 88.3% [85]. Furthermore, a few case reports have described favorable outcomes in neonates receiving fosfomycin as a combination therapy, including a case of methicillin-susceptible Staphylococcus aureus (MSSA) septicemia with liver abscesses and a case of cerebral abscess caused by Citrobacter koseri [86,87].…”

Randomised controlled trial of fosfomycin in neonatal sepsis: pharmacokinetics and safety in relation to sodium overload

“…18 19 Case reports totalling 84 neonates treated with intravenous fosfomycin 120-200 mg/kg/day suggest it is well-tolerated. [20][21][22][23][24] Toxicity among adults and older children appears low. 25 However, parenteral fosfomycin contains 14.4 mmol/330 mg sodium per gram-a potential safety concern in neonates whose sodium reabsorption is inversely proportional to gestational age (GA).…”

“…Case reports totalling 84 neonates treated with intravenous fosfomycin 120–200 mg/kg/day suggest it is well-tolerated 20–24. Toxicity among adults and older children appears low 25.…”

Fosfomycin: what was old is new again

“…Fosfomycin has not been systematically studied in children and neonates, but numerous reports have documented success for various indications. [14][15][16][17][18] Significant adverse effects have not been reported in this population despite prolonged courses in some cases. 14,19,20 Dosing regimens used in children vary considerably.…”