Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales - Université de Franche-Comté Accéder directement au contenu
Article Dans Une Revue Antibiotics Année : 2022

Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales

Kévin Bouiller
Souheil Zayet
Paul-Emile Lalloz
  • Fonction : Auteur
Anaïs Potron
Vincent Gendrin
Catherine Chirouze
Timothée Klopfenstein

Résumé

Background: Antimicrobial drugs to treat male urinary tract infection (UTI) with multidrug-resistant Enterobacterales are limited. We studied oral fosfomycin-trometamol (FT) in this situation. The objective was to assess the clinical cure rate in patients presenting UTIs treated with oral FT. Methods: We conducted a single-center observational retrospective study from January 2017 to August 2018. The primary endpoint was clinical cure; and the secondary endpoints were incidence of recurrences, oral FT safety, and microbiological cure. Results: Sixteen male patients were included, presenting 21 UTI episodes. Fourteen patients (88%) have at least one underlying urologic disorder. We described 4 episodes of acute UTI and 17 episodes of chronic bacterial prostatitis (CBP). Sixteen out of twenty-one Enterobacterales were extended spectrum beta-lactamase (ESBL)-producers and all the patients presented a resistance to fluoroquinolones and trimethoprim/sulfamethoxazole. In acute UTI, the regimen was a daily dose of oral FT for a mean duration of 2.5 weeks (+/−7.0 days). Clinical and microbiological recovery was achieved in all patients, with no recurrence after 5.3 months follow-up on average (+/−10.4 days). In CBP, the regimen was one oral dose of fosfomycin every 24–48 h, for a mean duration of 5.5 weeks/UTI episodes (+/−15.3 days). Clinical and microbiological recovery was found in 16/17 cases. Seven of the twelve patients with CBP had relapsed and 3/12 had had a new episode of infection after an average follow-up of 5.8 months. Only 6/21 of patients presented minor or moderate adverse effects, such as digestive disorders. Conclusions: FT could be an alternative option to carbapenems in the treatment of multidrug-resistant Enterobacterales infections for male UTIs.
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hal-04225981 , version 1 (16-02-2024)

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Kévin Bouiller, Souheil Zayet, Paul-Emile Lalloz, Anaïs Potron, Vincent Gendrin, et al.. Efficacy and Safety of Oral Fosfomycin-Trometamol in Male Urinary Tract Infections with Multidrug-Resistant Enterobacterales. Antibiotics, 2022, 11 (2), pp.198. ⟨10.3390/antibiotics11020198⟩. ⟨hal-04225981⟩
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