Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Feb 3;11(2):198.
doi: 10.3390/antibiotics11020198.

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Kévin Bouiller  1   2 , Souheil Zayet  3 , Paul-Emile Lalloz  1 , Anaïs Potron  4 , Vincent Gendrin  3 , Catherine Chirouze  1   2 , Timothée Klopfenstein  3
Affiliations

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Kévin Bouiller et al. Antibiotics (Basel). .

Abstract

Background: Antimicrobial drugs to treat male urinary tract infection (UTI) with multidrug-resistant Enterobacterales are limited. We studied oral fosfomycin-trometamol (FT) in this situation. The objective was to assess the clinical cure rate in patients presenting UTIs treated with oral FT.

Methods: We conducted a single-center observational retrospective study from January 2017 to August 2018. The primary endpoint was clinical cure; and the secondary endpoints were incidence of recurrences, oral FT safety, and microbiological cure.

Results: Sixteen male patients were included, presenting 21 UTI episodes. Fourteen patients (88%) have at least one underlying urologic disorder. We described 4 episodes of acute UTI and 17 episodes of chronic bacterial prostatitis (CBP). Sixteen out of twenty-one Enterobacterales were extended spectrum beta-lactamase (ESBL)-producers and all the patients presented a resistance to fluoroquinolones and trimethoprim/sulfamethoxazole. In acute UTI, the regimen was a daily dose of oral FT for a mean duration of 2.5 weeks (+/-7.0 days). Clinical and microbiological recovery was achieved in all patients, with no recurrence after 5.3 months follow-up on average (+/-10.4 days). In CBP, the regimen was one oral dose of fosfomycin every 24-48 h, for a mean duration of 5.5 weeks/UTI episodes (+/-15.3 days). Clinical and microbiological recovery was found in 16/17 cases. Seven of the twelve patients with CBP had relapsed and 3/12 had had a new episode of infection after an average follow-up of 5.8 months. Only 6/21 of patients presented minor or moderate adverse effects, such as digestive disorders.

Conclusions: FT could be an alternative option to carbapenems in the treatment of multidrug-resistant Enterobacterales infections for male UTIs.

Keywords: Enterobacterales; efficacy; fosfomycin; male urinary tract infections; prostatitis; safety.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Caron F., Galperine T., Flateau C., Azria R., Bonacorsi S., Bruyère F., Cariou G., Clouqueur E., Cohen R., Doco-Lecompte T., et al. Practice guidelines for the management of adult community-acquired urinary tract infections. Méd. Mal. Infect. 2018;48:327–358. doi: 10.1016/j.medmal.2018.03.005. - DOI - PubMed
    1. Zhanel G.G., Zhanel M.A., Karlowsky J.A. Oral Fosfomycin for the Treatment of Acute and Chronic Bacterial Prostatitis Caused by Multidrug-Resistant Escherichia coli. Can. J. Infect. Dis. Med. Microbiol. 2018;2018:1404813. doi: 10.1155/2018/1404813. - DOI - PMC - PubMed
    1. Talon D., Hocquet D., Bertrand X. Infections Nosocomiales. [(accessed on 11 January 2022)]. Available online: http://www.em-consulte.com/en/article/962550.
    1. Cantón R., Coque T.M. The CTX-M beta-lactamase pandemic. Curr. Opin. Microbiol. 2006;9:466–475. doi: 10.1016/j.mib.2006.08.011. - DOI - PubMed
    1. Demir T., Buyukguclu T. Evaluation of the in vitro activity of fosfomycin tromethamine against Gram-negative bacterial strains recovered from community- and hospital-acquired urinary tract infections in Turkey. Int. J. Infect. Dis. 2013;17:e966–e970. doi: 10.1016/j.ijid.2013.04.005. - DOI - PubMed

LinkOut - more resources