Efficacy and safety of intravenous fosfomycin for the treatment of carbapenem-resistant Klebsiella pneumoniae

Abstract

The aim of the study was to evaluate clinical and microbiological efficacy and safety of intravenous fosfomycin for the treatment of carbapenem-resistant K. pneumoniae infections. All adult inpatients receiving 48 h of intravenous fosfomycin, alone or combined with other antibiotics were included in the study. Overall favorable clinical response rate was 75.3% among 94 patients. Clinical response rates were 92.3%, 72.2% and 56.0% for urinary tract infections, bacteremia and pneumonia, respectively. Microbiological eradication was achieved in 55 of 86 patients. 30-day mortality was 33.0%. Adverse events were generally mild. Common adverse events were hypokalemia (37.2%) and hypernatremia (22.3%). Intravenous fosfomycin is an effective antibiotic option with a good safety profile for the treatment of carbapenem-resistant K. pneumoniae infections. The most favorable clinical and microbiological responses are obtained in urinary tract infections. The efficacy of the drug in more severe infections, such as pneumonia and bacteremia, is comparable to the literature.

Keywords:

• Intravenous fosfomycin
• carbapenem resistant
• K. pneumoniae
• clinical response
• mortality
• efficacy
• safety

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Conceptualization: Pınar AYSERT-YILDIZ, Murat DİZBAY; Methodology: Pınar AYSERT-YILDIZ, Özge ÖZGEN-TOP; Investigation: Özge ÖZGEN-TOP, Hamid HABİBİ; Writing original draft: Pınar AYSERT-YILDIZ, Hamid HABİBİ, Özge ÖZGEN-TOP; Writing – Review & Editing: Pınar AYSERT-YILDIZ, Murat DİZBAY; Supervision: Murat DİZBAY