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Potential of fosfomycin in treating multidrug-resistant infections in children

Phoebe Cm Williams1,2

  • 1Department of Infectious Diseases and Immunology, Sydney Children's Hospital, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|April 16, 2020
PubMed

Insights

Fosfomycin offers a promising treatment for multidrug-resistant infections in children, addressing critical antimicrobial resistance. This review explores its efficacy, safety, and pharmacokinetics in pediatric patients, including ongoing neonatal sepsis trials.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Pediatrics

Background:

  • Antimicrobial resistance poses a significant challenge in pediatric care, limiting treatment options for multidrug-resistant organisms.
  • Fosfomycin, classified as 'critically important' by the WHO, shows potential against resistant bacteria, including in sepsis cases.
  • The availability of both oral and parenteral formulations enhances its utility.

Purpose of the Study:

  • To review the spectrum of activity, efficacy, safety, and pharmacokinetics of fosfomycin in pediatric patients.
  • To highlight ongoing clinical trials investigating fosfomycin in neonatal sepsis.
  • To discuss limitations in current fosfomycin susceptibility standards, dosing, and resistance mechanisms.

Main Methods:

  • Literature review of published studies on fosfomycin in pediatric populations.
  • Analysis of pharmacokinetic and safety data from existing research.
  • Identification and summary of ongoing clinical trials in neonatal sepsis.

Main Results:

  • Fosfomycin demonstrates broad-spectrum activity against Gram-positive and Gram-negative organisms.
  • Published data suggests efficacy in treating pediatric infections.
  • Pharmacokinetic and safety profiles are being further elucidated through ongoing trials.

Conclusions:

  • Fosfomycin is a valuable therapeutic option for pediatric patients facing multidrug-resistant infections.
  • Further research, particularly in neonatal sepsis, will refine its clinical application.
  • Addressing challenges in susceptibility testing, dosing, and resistance is crucial for optimal use.
Keywords:
antimicrobial resistancecarbapenem-resistant Enterobacteriaceaeextended spectrum β-lactamasefosfomycinlegacy antibioticsneonatal sepsis

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