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

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. Method...

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Autores principales: Bouiller, Kévin, Zayet, Souheil, Lalloz, Paul-Emile, Potron, Anaïs, Gendrin, Vincent, Chirouze, Catherine, Klopfenstein, Timothée
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868337/
https://www.ncbi.nlm.nih.gov/pubmed/35203801
http://dx.doi.org/10.3390/antibiotics11020198
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author Bouiller, Kévin
Zayet, Souheil
Lalloz, Paul-Emile
Potron, Anaïs
Gendrin, Vincent
Chirouze, Catherine
Klopfenstein, Timothée
author_facet Bouiller, Kévin
Zayet, Souheil
Lalloz, Paul-Emile
Potron, Anaïs
Gendrin, Vincent
Chirouze, Catherine
Klopfenstein, Timothée
author_sort Bouiller, Kévin
collection PubMed
description 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.
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spelling pubmed-88683372022-02-25 Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales Bouiller, Kévin Zayet, Souheil Lalloz, Paul-Emile Potron, Anaïs Gendrin, Vincent Chirouze, Catherine Klopfenstein, Timothée Antibiotics (Basel) Article 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. MDPI 2022-02-03 /pmc/articles/PMC8868337/ /pubmed/35203801 http://dx.doi.org/10.3390/antibiotics11020198 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bouiller, Kévin
Zayet, Souheil
Lalloz, Paul-Emile
Potron, Anaïs
Gendrin, Vincent
Chirouze, Catherine
Klopfenstein, Timothée
Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title_full Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title_fullStr Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title_full_unstemmed Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title_short Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales
title_sort efficacy and safety of oral fosfomycin-trometamol in male urinary tract infections with multidrug-resistant enterobacterales
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868337/
https://www.ncbi.nlm.nih.gov/pubmed/35203801
http://dx.doi.org/10.3390/antibiotics11020198
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