A multicentre, retrospective audit of fosfomycin use for urinary tract infections in Australian children and adolescents
- Author(s)
- Purcell, R; Yeoh, D; Bowen, A; Britton, PN; Carr, JP; Chen, M; Cheung, K; Clark, J; Irwin, A; Lai, T; Lorenzen, U; Steer, A; Wen, S; Williams, P; Yap, N; Cooper, C; Gwee, A;
- Details
- Publication Year 2023-07-05,Volume 78,Issue #7,Page 1616-1621
- Journal Title
- Journal of Antimicrobial Chemotherapy
- Publication Type
- Research article
- Abstract
- BACKGROUND: Urinary tract infections (UTIs) due to MDR organisms are increasingly common. The lack of paediatric data on efficacious antibiotics makes UTI treatment particularly challenging. Data on the efficacy of fosfomycin use for UTI in children are variable. METHODS: We conducted a retrospective audit of children aged 0-18 years who were treated with fosfomycin for UTI at seven tertiary paediatric hospitals in Australia over a 7 year period, from 2014 to 2020. RESULTS: Ninety-one children with a median age of 5 years (range 2 months to 18 years) received oral fosfomycin for UTI. The majority (57/91, 63%) had one or more comorbidity, with the most common being renal tract anomalies (24/91, 26%). Fifty-nine (65%) had febrile UTI, 14/91 (15%) had pyelonephritis and 1/91 (1%) was bacteraemic. A majority (80/91, 88%) of urinary cultures had an ESBL-producing Gram-negative pathogen isolated. Fosfomycin susceptibility was evident in all 80 isolates tested. For uncomplicated UTI, the most common dose in children aged <1, 1-12 and >12 years was 1, 2 and 3 g, respectively. For complicated UTI, doses of 2 and 3 g were most common. The median duration of fosfomycin administration was 5 days (range 1-82). Clinical cure was achieved in 84/90 (93%); the six with treatment failure had underlying comorbidities. Overall, 2/91 (2%) children experienced drug-related adverse effects comprising gastrointestinal symptoms in both, which resolved after treatment discontinuation. CONCLUSIONS: Fosfomycin is well tolerated and associated with favourable treatment outcomes in children with UTI. Further research on the optimal dosing strategy is required.
- Publisher
- Oxford University Press
- Keywords
- Humans; Child; Adolescent; Infant; *Fosfomycin/adverse effects; Retrospective Studies; Australia/epidemiology; *Urinary Tract Infections/drug therapy/epidemiology; Anti-Bacterial Agents/adverse effects
- Department(s)
- Infectious Diseases
- PubMed ID
- 37190910
- Publisher's Version
- https://doi.org/10.1093/jac/dkad131
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2023-10-24 12:19:57
Last Modified: 2024-07-16 04:20:11