Acute infantile pneumonopathies treated with fosfomycin

Area of Science:

• Pediatric Infectious Diseases
• Pharmacokinetics
• Respiratory Medicine

Background:

• Acute pneumopathies are common childhood respiratory infections.
• Fosfomycin is an antibiotic with broad-spectrum activity.
• Understanding fosfomycin's efficacy and pharmacokinetics in pediatric respiratory infections is crucial.

Purpose of the Study:

• To evaluate the clinical efficacy and safety of fosfomycin in children with acute pneumopathies.
• To determine fosfomycin concentrations in plasma, sputum, and pleural fluid.
• To assess the pharmacokinetic profile of fosfomycin in pediatric patients.

Main Methods:

• A study involving 24 children (11 months to 12 years) with acute pneumopathies treated with fosfomycin (200 mg/kg/day).
• Clinical, radiological, biological, and bacteriological assessments were performed.
• Fosfomycin levels were measured in plasma, sputum, and pleural fluid (in cases of pleurisy) every 5 days.

Main Results:

• Favorable clinical, radiological, and biological outcomes were observed in 21 out of 24 children.
• Fosfomycin concentrations in sputum showed variable results, averaging 16.5-23.4% of plasma levels, indicating a cumulative effect.
• Pleural fluid concentrations ranged from 39-50%. One case required treatment suspension due to cutaneous necrosis; otherwise, toxicity was minimal.

Conclusions:

• Fosfomycin demonstrates favorable clinical outcomes and acceptable safety in treating pediatric acute pneumopathies.
• The pharmacokinetic data suggest adequate drug penetration into respiratory secretions and pleural fluid.
• Alternative administration routes may be preferred due to potential issues with intramuscular injections and phlebitis from intravenous administration in children.