Fosfomycin in infantile acute gastroenteritis

Area of Science:

• Pediatrics
• Infectious Diseases
• Pharmacology

Background:

• Infectious diarrhea is a common childhood illness.
• Antibiotic resistance is a growing concern in treating bacterial infections.
• Fosfomycin is a broad-spectrum antibiotic with potential utility in pediatric infections.

Purpose of the Study:

• To evaluate the clinical efficacy and safety of fosfomycin in children with infectious diarrhea.
• To assess the impact of fosfomycin treatment on fecal flora composition and antibiotic sensitivity.

Main Methods:

• A clinical trial involving 83 children with infectious diarrhea treated with oral or parenteral fosfomycin.
• Coprocultures performed before and after treatment to analyze bacterial flora.
• Antibiograms and Minimum Inhibitory Concentration (MIC) studies for fosfomycin sensitivity.
• Evaluation of clinical cure rates, treatment failures, and adverse effects.

Main Results:

• Fosfomycin achieved a 60/70 (85.7%) clinical cure rate in evaluable patients.
• Treatment led to the eradication of serotypeable E. coli, with a subsequent increase in Proteus sp. and Klebsiella/Enterobacter.
• High sensitivity of fecal flora to fosfomycin was observed, with >75% of strains inhibited at <32 µg/ml, except for Proteus sp. and Klebsiella/Enterobacter.
• Good tolerance was reported, with sporadic increases in SGPT as the only notable side effect.

Conclusions:

• Fosfomycin demonstrates significant clinical efficacy and good tolerance for treating infectious diarrhea in children.
• The antibiotic effectively targets E. coli while generally maintaining sensitivity in other fecal flora, though shifts in bacterial populations warrant monitoring.
• Fosfomycin represents a viable therapeutic option for pediatric infectious diarrhea, with careful consideration of its impact on the gut microbiome.