Shreya Das Adhikari, Souvik Chaudhuri, Carl Boodman, Mukund Gupta, Marco Schito, Heather Stone, Nitin Gupta
{"title":"磷霉素治疗非尿路感染:系统综述。","authors":"Shreya Das Adhikari, Souvik Chaudhuri, Carl Boodman, Mukund Gupta, Marco Schito, Heather Stone, Nitin Gupta","doi":"10.53854/liim-3102-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Although fosfomycin is currently approved for treating urinary tract infections, it is increasingly being used as salvage therapy for various infectious syndromes outside the urinary tract. This systematic review evaluates clinical and microbiological cure rates in patients with bacterial infections not restricted to the urinary tract where fosfomycin was used off-label.</p><p><strong>Materials and methods: </strong>Articles from two databases (Pubmed and Scopus) were reviewed. The dosage, route, and duration of fosfomycin therapy along with the details of adjunctive antimicrobial agents were noted. The final outcomes captured were clinical or microbiological cures.</p><p><strong>Results: </strong>A total of 649 articles, not including duplicates, were selected for the title and abstract screening. After title and abstract screening, 102 articles were kept for full-text screening. Of the 102 articles, 23 studies (n=1227 patients) were kept in the final analysis. Of the 1227 patients, 301 (25%) received fosfomycin as monotherapy, and the remaining 926 75%) received fosfomycin in combination with at least one other antimicrobial agent. Most of the patients received intravenous fosfomycin (n=1046, 85%). <i>Staphylococcus</i> spp and Enterobacteriaceae were the most common organisms. The pooled clinical and microbiological cure rates were 75% and 84%, respectively.</p><p><strong>Conclusion: </strong>Fosfomycin has moderate clinical success in patients with non-urinary tract infections, especially when used with other antimicrobials. Due to the paucity of randomized controlled trials, fosfomycin's use should be limited to situations where no alternatives are supported by better clinical evidence.</p>","PeriodicalId":52423,"journal":{"name":"Infezioni in Medicina","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241401/pdf/1124-9390_31_1_2023_163-173.pdf","citationCount":"0","resultStr":"{\"title\":\"Fosfomycin for Non-Urinary Tract Infections: a systematic review.\",\"authors\":\"Shreya Das Adhikari, Souvik Chaudhuri, Carl Boodman, Mukund Gupta, Marco Schito, Heather Stone, Nitin Gupta\",\"doi\":\"10.53854/liim-3102-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Although fosfomycin is currently approved for treating urinary tract infections, it is increasingly being used as salvage therapy for various infectious syndromes outside the urinary tract. This systematic review evaluates clinical and microbiological cure rates in patients with bacterial infections not restricted to the urinary tract where fosfomycin was used off-label.</p><p><strong>Materials and methods: </strong>Articles from two databases (Pubmed and Scopus) were reviewed. The dosage, route, and duration of fosfomycin therapy along with the details of adjunctive antimicrobial agents were noted. The final outcomes captured were clinical or microbiological cures.</p><p><strong>Results: </strong>A total of 649 articles, not including duplicates, were selected for the title and abstract screening. After title and abstract screening, 102 articles were kept for full-text screening. Of the 102 articles, 23 studies (n=1227 patients) were kept in the final analysis. Of the 1227 patients, 301 (25%) received fosfomycin as monotherapy, and the remaining 926 75%) received fosfomycin in combination with at least one other antimicrobial agent. Most of the patients received intravenous fosfomycin (n=1046, 85%). <i>Staphylococcus</i> spp and Enterobacteriaceae were the most common organisms. The pooled clinical and microbiological cure rates were 75% and 84%, respectively.</p><p><strong>Conclusion: </strong>Fosfomycin has moderate clinical success in patients with non-urinary tract infections, especially when used with other antimicrobials. Due to the paucity of randomized controlled trials, fosfomycin's use should be limited to situations where no alternatives are supported by better clinical evidence.</p>\",\"PeriodicalId\":52423,\"journal\":{\"name\":\"Infezioni in Medicina\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10241401/pdf/1124-9390_31_1_2023_163-173.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infezioni in Medicina\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.53854/liim-3102-4\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infezioni in Medicina","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.53854/liim-3102-4","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
Fosfomycin for Non-Urinary Tract Infections: a systematic review.
Introduction: Although fosfomycin is currently approved for treating urinary tract infections, it is increasingly being used as salvage therapy for various infectious syndromes outside the urinary tract. This systematic review evaluates clinical and microbiological cure rates in patients with bacterial infections not restricted to the urinary tract where fosfomycin was used off-label.
Materials and methods: Articles from two databases (Pubmed and Scopus) were reviewed. The dosage, route, and duration of fosfomycin therapy along with the details of adjunctive antimicrobial agents were noted. The final outcomes captured were clinical or microbiological cures.
Results: A total of 649 articles, not including duplicates, were selected for the title and abstract screening. After title and abstract screening, 102 articles were kept for full-text screening. Of the 102 articles, 23 studies (n=1227 patients) were kept in the final analysis. Of the 1227 patients, 301 (25%) received fosfomycin as monotherapy, and the remaining 926 75%) received fosfomycin in combination with at least one other antimicrobial agent. Most of the patients received intravenous fosfomycin (n=1046, 85%). Staphylococcus spp and Enterobacteriaceae were the most common organisms. The pooled clinical and microbiological cure rates were 75% and 84%, respectively.
Conclusion: Fosfomycin has moderate clinical success in patients with non-urinary tract infections, especially when used with other antimicrobials. Due to the paucity of randomized controlled trials, fosfomycin's use should be limited to situations where no alternatives are supported by better clinical evidence.
期刊介绍:
The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.