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Intravenous fosfomycin is increasingly used for severe infections, often in combination therapy. This study details its real-world administration, patient characteristics, and outcomes in Italian hospitals.

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Fosfomycin, an antibiotic with broad-spectrum activity and synergistic potential, is gaining renewed interest for treating severe infections.
  • Real-world data on the clinical use of intravenous fosfomycin, especially in combination therapies, remain limited.
  • Understanding its administration and effectiveness in diverse patient populations is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To characterize clinical and microbiological profiles of patients receiving intravenous fosfomycin.
  • To analyze the administration modalities and treatment outcomes of intravenous fosfomycin in a real-world setting.
  • To provide evidence supporting the use of intravenous fosfomycin in complex infections.

Main Methods:

  • Multicenter retrospective cohort study across five Italian hospitals.
  • Inclusion of adult patients treated with intravenous fosfomycin from January 2020 to December 2023.
  • Data collection on patient demographics, infection types, pathogen prevalence, combination therapies, dosages, and outcomes.

Main Results:

  • 393 patients were analyzed, with a median age of 69 years; most were in Critical Care Units.
  • Common indications included pneumonia (34%), bloodstream infections (22%), and urinary tract infections (21%), predominantly caused by Gram-negative bacteria.
  • Fosfomycin was frequently used empirically (55%) and in combination therapy (99%), with piperacillin/tazobactam and new beta-lactam/beta-lactamase inhibitors being common partners.

Conclusions:

  • This study offers significant real-world insights into intravenous fosfomycin usage in Italian hospitals.
  • Intravenous fosfomycin is a versatile agent, often employed in combination for severe Gram-negative infections.
  • Further research should focus on optimizing dosing and evaluating long-term efficacy and safety profiles.