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Current clinical use of intravenous fosfomycin in ICU patients in two European countries.
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; Gründling, M; Wahlers, T; Gerlach, H; Litty, F-A.
Afiliación
  • Putensen C; Department of Anesthesiology and Surgical Intensive Care Medicine, Medical School of the University of Bonn, Bonn, Germany.
  • Ellger B; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, Klinikum Westfalen GmbH, Dortmund, Germany.
  • Sakka SG; Department of Anesthesiology and Operative Intensive Care Medicine, Medical Center Cologne-Merheim, University of Witten/Herdecke, Cologne, Germany.
  • Weyland A; Department of Anesthesiology/Intensive Care Medicine/Emergency Medicine/Pain Therapy, Klinikum Oldenburg GmbH, Oldenburg, Germany.
  • Schmidt K; Department of Anesthesiology, Charité University Hospital Berlin, Berlin, Germany.
  • Zoller M; Department of Anesthesiology, University Hospital Munich, Munich, Germany.
  • Weiler N; Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig- Holstein, Campus Kiel, Kiel, Germany.
  • Kindgen-Milles D; Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany.
  • Jaschinski U; Department of Anesthesiology and Surgical Intensive Care Medicine, University Hospital Augsburg, Augsburg, Germany.
  • Weile J; Department of Thorax and Cardiovascular Medicine, Institute of Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Germany.
  • Lindau S; Department of Anesthesiology/Intensive Care Medicine/Pain Therapy, University Hospital Frankfurt, Frankfurt, Germany.
  • Kieninger M; Department of Anesthesiology and Neurosurgical Intensive Care Unit, University Hospital Regensburg, Regensburg, Germany.
  • Faltlhauser A; Interdisciplinary Intensive Care Unit, Weiden Hospital, Weiden, Germany.
  • Jung N; Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
  • Teschendorf P; Department of Anesthesiology and Surgical Intensive Care Medicine, Klinikum Osnabrück GmbH, Osnabrück, Germany.
  • Adamzik M; Department of Anesthesiology/Intensive Care Medicine/Pain Therapy, Knappschaftskrankenhaus Bochum, Bochum, Germany.
  • Gründling M; Department of Anesthesiology/Intensive Care Medicine/Emergency Medicine/Pain Therapy, University Hospital Greifswald, Greifswald, Germany.
  • Wahlers T; Department of Cardiothoracic Surgery, University Hospital of Cologne, Cologne, Germany.
  • Gerlach H; Department of Anesthesiology and Surgical Intensive Care Medicine, Klinikum Neukölln, Berlin, Germany.
  • Litty FA; InfectoPharm Arzneimittel und Consilium GmbH, Heppenheim, Germany. felix-alexander.litty@infectopharm.com.
Infection ; 47(5): 827-836, 2019 Oct.
Article en En | MEDLINE | ID: mdl-31190298
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Bacterianas / Administración Intravenosa / Fosfomicina / Unidades de Cuidados Intensivos / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Infection Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Bacterianas / Administración Intravenosa / Fosfomicina / Unidades de Cuidados Intensivos / Antibacterianos Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Infection Año: 2019 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania