An Old Molecule, a New Drug; The Role of Intravenous Fosfomycin in Clinical Use

Abstract

Purpose: Treatment of invasive infections caused by multidrug-resistant bacteria is getting more difficult. Problems in the development of new antibiotics have led to the use of fosfomycin, an old molecule that has a broad spectrum. In this study, it was aimed to discuss the real life data of intravenous fosfomycin in our clinical practice. Materials and methods: Patients who were treated with IV fosfomycin in Ondokuz Mayıs University Medical Faculty Hospital were included in the study. Results: A total of 36 patients, 18 (50%) male and 18 (50%) female, were included in the study. The mean age of the patients was 62.5±17.0 (18-90) years. 34.2% of the patients who used intravenous fosfomycin were in the intensive care unit. Indication of iv fosfomycin use was found to be upper urinary tract infection in 30 patients (83.3%), lower respiratory tract infection in three patients (8.3%), bone-joint infection in two patients (5.5%), bloodstream infection in one patient (2%). The causative microorganism was Klebsiella pneumoniae 75%, Providencia retgerii 19.4%, and Escherichia coli 5.6%. Microbiological cure occurred in 72.7% of the patients. The mean duration use of IV fosfomycin was 8.6±4.1 days, and the average daily dose was 13.11±4.4 g. It was found that 16.7% of the patients developed hypernatremia. It was observed that fosfomycin was used in combination therapy in half of the study patients. In combination therapies, it is most frequently combined with a 33.3% carbapenem. When monotherapy and combination therapy were compared, no difference was found between the groups in terms of microbiological response, side effects and 14-day mortality. © 2022, Pamukkale University. All rights reserved.