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Abstract:
This report deals with the study made of the treatment of 45 acute, subacute and chronic urinary infections in a department of general medicine. 43 of these were infections caused by a single species of bacteria and 3 were caused by more than one species. The sensitivity test of the isolated organisms (E. coli, Proteus, Serratia, Pseudomonas, Klebsiella and S. faecalis) showed 83.33% of the strains to be senstive and 16.8% of the strains to be resistant. Nevertheless, this last group of strains, with the exception of one Pseudomonas, proved to be sensitive to the association of fosfomycin with a beta-lactamin (carbenicillin, amoxycillin) or an aminoglycoside (gentamicin, tobramycin). Of a total of 45 cases, 34 were exclusively treated with fosfomycin (2 g by the intramuscular route and 2 g by the oral route) and 11 cases were treated with a double association of fosfomycin with a beta-lactamin (carbenicillin or amoxycillin) or an aminoglycoside (gentamicin), after having studied the bactericidal activity of the association in vitro. The clinical and bacteriological results were verified 4 weeks after the conclusion of the treatment and showed that there was an eradication of the urinary infection in 34 cases (75.55%), relapses in 6 cases (13.33%) and reinfections in 5 cases (11.22%). These results would seem to be favourable with regards to hospital infections and with respect to organisms that are considered to be very little sensitive or resistant.
Insights
Fosfomycin effectively treats urinary tract infections (UTIs), with 75.55% eradication rates. Resistant bacteria often respond to fosfomycin combined with other antibiotics.
Area of Science:
- Infectious Diseases
- Pharmacology
- Urology
Background:
- Urinary tract infections (UTIs) are common, often caused by bacterial pathogens.
- Antibiotic resistance is a growing concern in treating UTIs, necessitating evaluation of alternative therapies.
- Fosfomycin is an antibiotic with broad-spectrum activity, including against common UTI pathogens.
Purpose of the Study:
- To evaluate the efficacy of fosfomycin, alone and in combination therapy, for treating acute, subacute, and chronic UTIs.
- To assess treatment outcomes in relation to bacterial sensitivity and resistance patterns.
Main Methods:
- A study involving 45 patients with UTIs treated with fosfomycin or fosfomycin combined with beta-lactams or aminoglycosides.
- Bacterial sensitivity testing was performed on isolated organisms (E. coli, Proteus, Serratia, Pseudomonas, Klebsiella, S. faecalis).
- Clinical and bacteriological outcomes were assessed four weeks post-treatment.
Main Results:
- 83.33% of bacterial strains were sensitive to fosfomycin; 16.8% were resistant.
- Resistant strains, except one Pseudomonas, responded to fosfomycin combined with beta-lactams or aminoglycosides.
- Overall, 75.55% of patients achieved eradication of their UTI, with 13.33% experiencing relapses and 11.22% reinfections.
Conclusions:
- Fosfomycin monotherapy and combination therapy demonstrate favorable outcomes in treating UTIs, including those caused by resistant bacteria.
- These findings support the use of fosfomycin in managing hospital-acquired UTIs and infections with challenging pathogens.
- Combination therapy with fosfomycin offers a viable option for infections involving antibiotic-resistant strains.