Abstract
We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem particularly in patients who we would like to treat on an outpatient basis. We retrospectively analyzed the medical records of all patients who admitted to infectious disease outpatient clinic with complaints of dysuria and frequency and received FT for lower UTI between May 2016 and May 2017. A total of 48 patients, 19 females (39.6%) and 29 males (60.4%), with a mean age of 62.5 (ranging from 27 to 85) years were included the study. 26 (76.4%) of patients with a history of urinary operation or intervention had also a history of antibiotic use within the past 3 months. The isolated pathogens included Escherichia Coli (n = 32), Klebsiella spp. (n = 12), Enterobacter spp. (n = 4). The overall microbiological response after treatment was 70.8% (34/48) and the clinical response was 75% (36/48). Clinical and microbiological response rates of patients with and without urinary operation/intervention, diabetes mellitus, history of antibiotic use and malignancy were found similar (p > 0.05). However, patients with a urinary stone disease history had significantly higher response rates than those without a urinary stone disease history (P = 0.042). Oral fosfomycin tromethamine might be the treatment of choice in ESBL-producing enterobactericea related UTIs especially caused by Escherichia Coli.
Highlights
We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae strains as an alternative to carbapenem in patients who we would like to treat on an outpatient basis
The aim of this study is to demonstrate if FT treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem in patients who we would like to treat on an outpatient basis
After the approval of institutional review board, we retrospectively analyzed the medical records of all patients who admitted to infectious disease outpatient clinic with complaints of dysuria and frequency and received Fosfomycin tromethamine for lower Urinary tract infections (UTIs) between May 2016 and May 2017
Summary
We aimed to demonstrate if fosfomycin tromethamine (FT) treatment could be the treatment of choice in ESBL-producing Enterobacteriaceae strains as an alternative to carbapenem in patients who we would like to treat on an outpatient basis. Clinical and microbiological response rates of patients with and without urinary operation/intervention, diabetes mellitus, history of antibiotic use and malignancy were found similar (p > 0.05). Conclusion: Oral fosfomycin tromethamine might be the treatment of choice in ESBL-producing enterobactericea related UTIs especially caused by Escherichia Coli. Urinary tract infections (UTIs) are one of the most common infections both in inpatient and outpatient populations The majority of these infections are uncomplicated lower UTIs. UTIs caused by Enterobacteriaceae, which produces extended spectrum beta-lactamase (ESBL), are seen all over the world as well as increasing frequency in our country [1,2]. For community-associated ESBL infection; previous antibiotic use, recurrent UTIs, diabetes mellitus, urinary instrumentation, female sex and being over 65 years old are considered as risk factors [3]. Carbapenems are the most reliable antibiotics for infections caused by ESBL producing
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