Fosfomycin useful treatment option for uncomplicated cystitis among females

The study was done to report the resistance rate against fosfomycin trometamol among outpatient women with symptoms related to UTI during a 6 years-period in a multicentre cross-sectional study.

Urinary samples were collected from three high volume laboratories from January 2015 to December 2020. The pattern of resistance to fosfomycin was analysed by using the Vitek II automated system.

Results

During the study period 7,289 urinary samples were collected and 8,321 strains were analysed. Escherichia coli was the most common isolated uropathogens (n=6,583, 79.1%). The mean resistance rate against fosfomycin was 9.7% (ranging from 7.1 to 11.3). No statistically significant difference was found between the three laboratories (p=0.53). There was no significant increase in resistance rate during the study period. The mean resistance rate against fosfomycin was higher among ESBL-producing bacteria when compared with no ESBL-producing strains (10.8% vs 7.9%, p<0.001).

Uropathogens isolated from women affected by cystitis remained highly susceptible to fosfomycin. Our findings confirm recommendations in international guidelines that advocate fosfomycin trometamol for empirical treatment of uncomplicated cystitis in women.

Keywords: Fosfomycin; urinary tract infections; Resistance; antibiotics; Antibiotic Stewardship

Reference:

Tommaso Cai, Paolo Verze, Davide Arcaniolo, Savio Domenico Pandolfo, Francesco Smarrazzo, Celeste Mandredi, Carlo Tascini, Patrizio Caciagli, Massimiliano Lanzafame, Marco De Sio, Florian Wagenlehner, Truls E. Bjerklund Johansen, Alessandro Palmieri. ANTIBIOTIC RESISTANCE PATTERNS AMONG UROPATHOGENS IN FEMALE OUTPATIENTS AFFECTED BY UNCOMPLICATED CYSTITIS: FOCUS ON FOSFOMYCIN TROMETAMOL, International Journal of Antimicrobial Agents, 2023, 106974, ISSN 0924-8579, https://doi.org/10.1016/j.ijantimicag.2023.106974

(https://www.sciencedirect.com/science/article/pii/S0924857923002534)

Keywords:

Local, bacterial, resistance, patterns, assessment, focus, first-line, UTI, antibiotics, International Journal of Antimicrobial Agents, Tommaso Cai, Paolo Verze, Davide Arcaniolo, Savio Domenico Pandolfo, Francesco Smarrazzo, Celeste Mandredi, Carlo Tascini, Patrizio Caciagli, Massimiliano Lanzafame, Marco De Sio, Florian Wagenlehner, Truls E. Bjerklund Johansen, Alessandro Palmieri