Universität zu Köln

Putensen, C., Ellger, B., Sakka, S. G., Weyland, A., Schmidt, K., Zoller, M., Weiler, N., Kindgen-Milles, D., Jaschinski, U., Weile, J., Lindau, S., Kieninger, M., Faltlhauser, A., Jung, N., Teschendorf, P., Adamzik, M., Gruendling, M., Wahlers, T., Gerlach, H. and Litty, F. -A. (2019). Current clinical use of intravenous fosfomycin in ICU patients in two European countries. Infection, 47 (5). S. 827 - 837. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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Abstract

Purpose In Europe, intravenous fosfomycin (IV) is used particularly in difficult-to- treat or complex infections, caused by both Gram-positive and Gram-negative pathogens including multidrug-resistant strains. Here, we investigated the efficacy and safety of intravenous fosfomycin under real-life conditions. Methods Prospective, multi-center, and non-interventional study in patients with bacterial infections from 20 intensive care units (ICU) in Germany and Austria (NCT01173575). Results Overall, 209 patients were included (77 females, 132 males, mean age: 59 +/- 16 years), 194 of which were treated in intensive care (APACHE II score at the beginning of fosfomycin therapy: 23 +/- 8). Main indications (+/- bacteremia or sepsis) were infections of the CNS (21.5%), community- (CAP) and hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP, 15.3%), bone and joint infections (BJI, 11%), abdominal infections (11%), and bacteremia (10.5%). Most frequently identified pathogens were S. aureus (22.3%), S. epidermidis (14.2%), Enterococcus spp. (10.8%), E. coli (12.3%) and Klebsiella spp. (7.7%). At least one multidrug-resistant (MDR) pathogen was isolated from 51 patients (24.4%). Fosfomycin was administered with an average daily dose of 13.7 +/- 3.5 g over 12.4 +/- 8.6 days, almost exclusively (99%) in combination with other antibiotics. The overall clinical success was favorable in 81.3% (148/182) of cases, and in 84.8% (39/46) of patients with >= 1 MDR pathogen. Noteworthy, 16.3% (34/209) of patients developed at least one, in the majority of cases non-serious, adverse drug reaction during fosfomycin therapy. Conclusion Our data suggest that IV fosfomycin is an effective and safe combination partner for the treatment of a broad spectrum of severe bacterial infections in critically ill patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Putensen, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ellger, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sakka, S. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weyland, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoller, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiler, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kindgen-Milles, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaschinski, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weile, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lindau, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kieninger, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Faltlhauser, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jung, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Teschendorf, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Adamzik, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gruendling, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Litty, F. -A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-131641
DOI:	10.1007/s15010-019-01323-4
Journal or Publication Title:	Infection
Volume:	47
Number:	5
Page Range:	S. 827 - 837
Date:	2019
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSIVE-CARE-UNIT; MULTIDRUG-RESISTANT; CEREBROSPINAL-FLUID; ESCHERICHIA-COLI; STAPHYLOCOCCUS-AUREUS; KLEBSIELLA-PNEUMONIAE; INFECTIONS; CARBAPENEMS; TIGECYCLINE; EFFICACY Multiple languages Infectious Diseases Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13164