Fosfomycin in Complicated Intra-Abdominal Infections in an Intensive Care Setting: Does It Improve the Outcome? A...

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Pharmacology

Background:

• Intra-abdominal infections (IAI) present significant challenges with high morbidity and mortality.
• Fosfomycin is an approved antibiotic for combination therapy in treating IAIs.
• Evaluating intravenous fosfomycin's impact in intensive care settings is crucial for optimizing IAI treatment.

Purpose of the Study:

• To assess the effect of adding intravenous fosfomycin to combination regimens for IAI.
• To compare clinical response and in-hospital mortality in intensive care unit (ICU) patients.
• To identify risk factors associated with mortality in IAI patients.

Main Methods:

• Retrospective, observational, monocentric study including 104 ICU patients with IAIs.
• Patients divided into two groups: standard treatment (Group A) and standard treatment plus intravenous fosfomycin (Group B).
• Primary endpoints: clinical response at 7 days and in-hospital mortality; secondary: risk factor analysis for mortality.

Main Results:

• Groups were demographically homogenous, but Group B had a worse initial clinical condition.
• Clinical response at 7 days (81.2% vs. 73.7%) and in-hospital mortality (27.1% vs. 47.2%) were comparable between groups.
• Charlson Comorbidity Index and septic shock were mortality risk factors; effective empirical therapy was protective; fosfomycin showed no direct outcome association.

Conclusions:

• No significant difference in outcomes was observed between standard treatment and fosfomycin combination therapy for IAIs.
• Fosfomycin was administered to patients with greater illness severity and delayed source control, indicating its use in complex cases.
• Further research may be needed to define the specific role of fosfomycin in severe intra-abdominal infections.