Oral fosfomycin for the treatment of chronic bacterial prostatitis

The Journal of Antimicrobial Chemotherapy
Ilias KaraiskosEleni Giamarellou

Abstract

Chronic bacterial prostatitis (CBP) is a difficult-to-treat infection as only a few antibiotics achieve therapeutic concentrations in the prostate. Data on the efficacy and safety of oral fosfomycin for the treatment of CBP are limited. To analyse the efficacy and safety of fosfomycin in CBP due to MDR pathogens. In a prospective observational study, an oral regimen of 3 g of fosfomycin q24h for 1 week followed by 3 g q48h for a treatment duration of 6-12 weeks was administered. The outcome was clinical and microbiological cure rate at the end of treatment (EOT) and rate of relapse at 3 and 6 months. The study included 44 patients. The most common pathogen was Escherichia coli (66%), followed by Klebsiella spp. (14%) and Enterococcus faecalis (14%). Most strains were MDR (59%) and 23% had an ESBL phenotype; 33 of 44 strains were resistant to fluoroquinolones, but all were susceptible to fosfomycin (median MIC for Gram-negative pathogens 1.5 mg/L). In 25 patients, treatment was administered for 6 weeks, whereas in the remaining 19 patients it was prolonged to 12 weeks based on the presence of calcifications in the prostate. Cure rate was 82% at EOT and 80% and 73% at 3 and 6 months accordingly. Microbiological eradication was ac...Continue Reading

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Citations

Oct 1, 2019·Current Opinion in Infectious Diseases·Matteo BassettiDaniele Roberto Giacobbe
Jun 4, 2020·Current Urology Reports·Zhuo Tony SuAmin Sedaghat Herati
Feb 9, 2020·Antibiotics·Ilias Karaiskos, Helen Giamarellou
May 20, 2020·Frontiers in Pharmacology·Situ XiongBin Fu
Jul 30, 2020·International Journal of Antimicrobial Agents·Alex C F Kwan, Nathan P Beahm
Oct 31, 2020·Frontiers in Pharmacology·Vittorio MagriGianpaolo Perletti
Jun 22, 2021·Frontiers in Microbiology·Erick Adrian Cruz-LópezVirgilio Bocanegra-García
Jul 15, 2021·Expert Opinion on Drug Safety·Gianpaolo PerlettiVittorio Magri
Sep 19, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Yoshikazu Togo

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