The use of oral fosfomycin-trometamol in patients with catheter-associated urinary tract infections (CAUTI): new indications for an old antibiotic?

We present the results of a multicenter retrospective study of 35 difficult-to-treat patients with urinary tract infections associated with indwelling urinary catheters (CAUTIs). All patients received oral administration of 3 g fosfomycin trometamol once a day for two days and then with a dose of 3 g every 48 h for two weeks. The most commonly isolated strains were: Escherichia coli (65.7%) and Enterococcus spp. (25.7%); prevalence of Extended-Spectrum Beta-Lactamase strains was 48.5%. Six patients (17.1%) had a clinical response after a single dose of fosfomycin trometamol, 12 (34.2%) after two doses and 13 (37.1%) patients had a clinical response after three or more doses. Four patients (11.6%) failed prolonged antibiotic treatment with fosfomycin trometamol. During the follow-up period, 30 out of 35 (85.7%) patients were without symptomatic infections. No significant side effects were reported. In conclusion, fosfomycin trometamol seems to be a valid treatment option in patients with CAUTIs.

Journal of chemotherapy (Florence, Italy). 2018 Sep [Epub]

Tommaso Cai, Andrea Cocci, Paolo Verze, Michele Rizzo, Alessandro Palmieri, Giovanni Liguori, Carlo Trombetta, Chiara Adembri, Marco Carini, Riccardo Bartoletti, Florian M Wagenlehner, Gernot Bonkat, Vincenzo Mirone, Truls E Bjerklund Johansen, Andrea Novelli

a Department of Urology , Santa Chiara Regional Hospital , Trento , Italy., b Department of Urology , University of Florence , Florence , Italy., c Department of Urology , University of Naples, Federico II , Naples , Italy., d Department of Urology , University of Trieste , Trieste , Italy., e Department of Health Sciences, Section of Anesthesiology and Critical Care , University of Florence , Florence , Italy., f Department of Urology , University of Pisa , Pisa , Italy., g Klinik und Poliklinik für Urologie, Kinderurologie und Andrologie , Universitätsklinikum Giessen und Marburg GmbH, Justus-Liebig-Universität Giessen , Giessen , Germany., h Alta uro AG, Merian Iselin Klinik, Center of Biomechanics & Calorimetry (COB) , University Basel , Basel , Switzerland., i Department of Urology , Oslo University Hospital and University of Oslo , Oslo , Norway., j Department of Health Sciences , University of Florence , Florence , Italy.