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Intravenous Fosfomycin for Difficult-to-Treat Infections: A Real-Life Multicentric Study in Italy

Title: Intravenous Fosfomycin for Difficult-to-Treat Infections: A Real-Life Multicentric Study in Italy
Authors: Zerbato, Verena; Sanson, Gianfranco; Fusaro, Lisa; Gerussi, Valentina; Sincovich, Sara; Dellai, Fabiana; Del Fabro, Giovanni; Geremia, Nicholas; Maurel, Cristina; Giacomazzi, Donatella; Biasinutto, Chiara; Di Girolamo, Filippo Giorgio; Scrivo, Gianfranco; Costantino, Venera; Di Santolo, Manuela; Busetti, Marina; Crocè, Lory Saveria; Giuliano, Simone; Crapis, Massimo; Zhanel, George; Tascini, Carlo; Luzzati, Roberto; Di Bella, Stefano
Contributors: Zerbato, Verena; Sanson, Gianfranco; Fusaro, Lisa; Gerussi, Valentina; Sincovich, Sara; Dellai, Fabiana; Del Fabro, Giovanni; Geremia, Nichola; Maurel, Cristina; Giacomazzi, Donatella; Biasinutto, Chiara; Di Girolamo, Filippo Giorgio; Scrivo, Gianfranco; Costantino, Venera; Di Santolo, Manuela; Busetti, Marina; Crocè, Lory Saveria; Giuliano, Simone; Crapis, Massimo; Zhanel, George; Tascini, Carlo; Luzzati, Roberto; Di Bella, Stefano
Publication Year: 2025
Collection: Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste)
Subject Terms: intravenous fosfomycin; difficult-to-treat infection; multidrug resistance
Description: Background: Fosfomycin, an old antibiotic attracting renewed interest, offers a broad spectrum of activity and unique synergy with other agents. While widely used in severe infections, real-world data on intravenous fosfomycin remain limited. Objectives: This study aimed to describe the clinical and microbiological characteristics of patients treated with intravenous fosfomycin and to analyze its administration modalities in a real-world setting. Methods: A multicenter retrospective cohort study was conducted across five Italian hospitals. Adult patients receiving intravenous fosfomycin between January 2020 and December 2023 were included. Results: We enrolled 393 patients. The median age was 69 years, with most patients (45%) admitted to Critical Care Units. Pneumonia (34%), bloodstream infections (22%), and urinary tract infections (21%) were the most common indications. Gram-negative bacteria, particularly E. coli and P. aeruginosa, were the predominant pathogens. Fosfomycin was used as empirical therapy in 55% of cases and was combined with other agents in almost all cases (99%). The most frequent partners were piperacillin/tazobactam (21%) and new beta-lactam/beta-lactamase inhibitor combinations (18%). The median treatment duration was seven days, with most subjects (65%) receiving a fosfomycin dosage regimen of 16 g/day. Minimum inhibitory concentrations (MICs) values for fosfomycin were available for 61 isolates (15%), with 78.7% (48/61) showing MIC ≤ 32 mg/L. C. difficile infection occurred in only 2% of patients. Mortality rates at 30, 60, and 90 days were 21.6%, 26.7%, and 29.3%, respectively. Conclusions: This study provides valuable insights into the real-world use of intravenous fosfomycin.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40298561; info:eu-repo/semantics/altIdentifier/wos/WOS:001474685500001; volume:14; issue:4; firstpage:"-"; lastpage:"-"; numberofpages:9; journal:ANTIBIOTICS; https://hdl.handle.net/11368/3108006
DOI: 10.3390/antibiotics14040401
Availability: https://hdl.handle.net/11368/3108006; https://doi.org/10.3390/antibiotics14040401; https://www.mdpi.com/2079-6382/14/4/401
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.98D30EF5
Database: BASE