Fosfomycin for the treatment of infections caused by multidrug-resistant non-fermenting Gram-negative bacilli: a systematic review of microbiological, animal and clinical studies

摘要: The treatment of multidrug-resistant (MDR), extensively drug-resistant or pandrug-resistant non-fermenting Gram-negative bacterial infections constitutes a challenge in an era few new antibiotic choices. This mandates the re-evaluation already existing antibiotics such as fosfomycin. We systematically reviewed literature to assess clinical and microbiological effectiveness fosfomycin these by searching PubMed, Scopus Cochrane Library databases. In 23 studies identified, 1859 MDR isolates were examined. susceptibility rate Pseudomonas aeruginosa was >or=90% 50-90% 7/19 4/19 relevant studies, respectively. Cumulatively, 511/1693 (30.2%) P. susceptible Serotype O12 exhibited greater susceptibility. Only 3/85 (3.5%) Acinetobacter baumannii 0/31 Burkholderia spp. Variable criteria used included studies. Fosfomycin synergistic combination with beta-lactam, aminoglycoside ciprofloxacin 46/86 (53.5%) isolates. One animal study found good therapeutic effect fosfomycin/gentamicin against endocarditis. six 33 patients (mainly pulmonary exacerbations cystic fibrosis) received (25/33 other antibiotics); 91% clinically improved. conclusion, could have role option infections. Further research is needed clarify potential utility this agent.