Fosfomycin for the treatment of prostate infection.

Published on Jan 1, 2014in Internal Medicine1.005
· DOI :10.2169/INTERNALMEDICINE.53.3098
Hideharu Hagiya13
Estimated H-index: 13
(Okayama University),
Megumi Ninagawa1
Estimated H-index: 1
(Okayama University)
+ 6 AuthorsFumio Otsuka35
Estimated H-index: 35
(Okayama University)
A 69-year-old man with diabetes mellitus was diagnosed with a prostate abscess. Although the pathogen was fluoroquinolone-resistant Escherichia coli and the oral administration of trimethoprim-sulfamethoxazole was initiated, the infection recurred after three months. The antibiotic therapy was subsequently changed to intravenous fosfomycin, and the patient's condition promptly improved. Four weeks of fosfomycin therapy was successfully continued without any adverse events. In the era of antibiotic resistance, revival of forgotten drugs is an important issue for clinicians. Fosfomycin can be applied as an alternative option for prostate infections, considering the remaining susceptibility of multidrug-resistant pathogens to fosfomycin and the good pharmacokinetics of this drug in prostatic tissue.
#2A. A. MahonyH-Index: 1
Last. M. L. Grayson (University of Melbourne)H-Index: 1
view all 8 authors...
Background. Multidrug-resistant gram-negative bacterial (MDR-GNB) infections of the prostate are an increasing problem worldwide, particularly complicating transrectal ultrasound (TRUS)–guided prostate biopsy. Fluoroquinolonebased regimens, once the mainstay of many protocols, are increasingly ineffective. Fosfomycin has reasonable in vitro and urinary activity (minimum inhibitory concentration breakpoint ≤64 µg/mL) against MDR-GNB, but its prostatic penetration has been uncertain, so it has not...
64 CitationsSource
#1Helen W. Boucher (Tufts University)H-Index: 33
#2George H. TalbotH-Index: 53
Last. David N. Gilbert (OHSU: Oregon Health & Science University)H-Index: 37
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Infections caused by antibiotic-resistant bacteria, especially the “ESKAPE” pathogens, continue to increase in frequency and cause significant morbidity and mortality. New antimicrobial agents are greatly needed to treat infections caused by gram-negative bacilli (GNB) resistant to currently available agents. The Infectious Diseases Society of America (IDSA) continues to propose legislative, regulatory, and funding solutions to this continuing crisis. The current report updates the status of dev...
526 CitationsSource
Summary Fosfomycin, originally named phosphonomycin, was discovered in Spain in 1969. There are three forms of fosfomycin: fosfomycin tromethamine (a soluble salt) and fosfomycin calcium for oral use, and fosfomycin disodium for intravenous use. Fosfomycin is a bactericidal antibiotic that interferes with cell wall synthesis in both Gram-positive and Gram-negative bacteria by inhibiting the initial step involving phosphoenolpyruvate synthetase. It has a broad spectrum of activity against a wide ...
227 CitationsSource
#1Benjamin A. Lipsky (UW: University of Washington)H-Index: 95
#2I. Byren (John Radcliffe Hospital)H-Index: 17
Last. Christopher T. HoeyH-Index: 6
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Prostatitis is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction. Up to 25% of men receive a diagnosis of prostatitis in their lifetime, but !10% have a proven bacterial infection. The causes and treatment of nonbacterial prostatitis are largely unknown, but bacterial prostatitis is caused by infection with uropathogens, especially gram-negative bacilli, although infection is sometimes due to gram-positive and atypical microorganisms. Ac...
175 CitationsSource
#1Matthew E. Falagas (Tufts University)H-Index: 130
#2Antonia C. Kastoris (ALFA)H-Index: 9
Last. Drosos E. Karageorgopoulos (ALFA)H-Index: 51
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Summary Rising rates of resistance to antimicrobial drugs among Enterobacteriaceae limit the choice of reliably active forms of these drugs. We evaluated the evidence on fosfomycin as a treatment option for infections caused by members of the family Enterobacteriaceae with advanced resistance to antimicrobial drugs, including producers of extended-spectrum β-lactamase (ESBL). We systematically reviewed studies evaluating the antimicrobial activity, or the clinical effectiveness of fosfomycin. 17...
502 CitationsSource
#1Louis B. Rice (Case Western Reserve University)H-Index: 71
The continued evolution of antimicrobial resistance in the hospital and more recently in the community threatens to seriously compromise our ability to treat serious infections. The major success of the seven-valent Streptococcus pneumoniae vaccine at reducing both infection and resistance has been followed by the emergence of previously minor serotypes that express multiresistance. The almost universal activity of cephalosporins and fluoroquinolones against community Escherichia coli strains ha...
303 CitationsSource
#1Evangelos Aravantinos (UTH: University of Thessaly)H-Index: 8
#2Nikolaos KalogerasH-Index: 3
Last. Michael D. MelekosH-Index: 19
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Background and purpose: A novel approach for continuous drainage of prostatic abscesses is presented and discussed. Patients and methods: We present seven cases diagnosed with prostatic abscess during 2001–2007. The diagnosis was based on either clinical or transrectal ultrasound (TRUS) findings. All patients were initially treated as prostatitis cases by intravenous antibiotics, a1 blockers, and a suprapubic catheter. Those diagnosed with an abscess had a drainage tube placed transrectally unde...
26 CitationsSource
#1Matthew E. Falagas (Tufts University)H-Index: 130
#2Konstantina P. Giannopoulou (ALFA)H-Index: 9
Last. Petros I. Rafailidis (ALFA)H-Index: 54
view all 4 authors...
The shortage of new antimicrobial agents has made the scientific community reconsider the potential value of old antibiotics. A search of the literature was performed to compile relevant evidence regarding the effectiveness and safety of fosfomycin for the treatment of patients with gram-positive and/or gram-negative bacterial infections (excluding urinary tract infection and gastrointestinal infection). Of 1311 potentially relevant studies, 62 studies were reviewed in detail. Of 1604 patients w...
321 CitationsSource
A 38-year-old man reports pelvic pain, dysuria, and urinary urgency for the past 4 weeks. He has had several similar episodes over the past 2 years; urine cultures were not performed. He is sexually active and reports frequent discomfort after ejaculation. He is otherwise healthy and takes no medication. He has no fever, chills, or flank pain. How should he be evaluated and treated?
225 CitationsSource
Abstract In 2001, fluoroquinolone-resistant Escherichia coli isolates emerged in Japan in patients with uncomplicated urinary tract infection (UTI), and accounted for ca. 8% of isolates. This is a worldwide occurrence as reported by the ECO.SENS study. The number of fluoroquinolone- and cephem-resistant Enterobacteriaceae isolates from patients with complicated UTI is increasing. Most cephem-resistant isolates of E. coli , Klebsiella pneumoniae and Proteus mirabilis produce extended-spectrum β-l...
60 CitationsSource
Cited By5
#1Miroslav Fajfr (Charles University in Prague)H-Index: 2
#2Michal Balík (Charles University in Prague)H-Index: 3
Last. Pavel BostikH-Index: 18
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Fosfomycin represents a relatively old antibiotic, but it is experiencing a comeback in recent years. According to some studies, the increasing therapeutic use of this drug led to a rapid increase in the levels of resistance in bacteria causing urinary tract infection. In the presented study, levels of resistance to fosfomycin in more than 3500 bacterial isolates before and after fosfomycin introduction into therapeutic use in the Czech Republic and the clinical efficacy of treatment in 300 pati...
#1Alex C.F. Kwan (U of A: University of Alberta)
#2Nathan P Beahm (U of A: University of Alberta)H-Index: 5
Abstract There has been growing interest in fosfomycin for the treatment of bacterial prostatitis due to evidence suggesting it achieves adequate prostatic concentrations for antimicrobial effect, its activity against resistant microorganisms, and its low-toxicity profile. This review evaluated the current clinical evidence for fosfomycin in acute and chronic bacterial prostatitis to elucidate the clinical implications of fosfomycin in an era of increasing antimicrobial resistance. PubMed, Scopu...
#1Li FanH-Index: 1
#2Xue-Jun Shang (NU: Nanjing University)H-Index: 3
Last. Qi Zhang (Nanjing Tech University)H-Index: 17
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: In this study, we assessed the therapeutic effects of fosfomycin tromethamine (FT) in a bacterial prostatitis (BP) rat model. The BP model was induced by Escherichia coli and was demonstrated after 7 days microbiologically and histologically. Then, 25 BP rats selected were randomly divided into five treatment groups: model group, positive group, FT-3 day group, FT-7 day group and FT-14 day group. Ventral lobes of prostate from all animals were removed, and the serum samples were collected at t...
3 CitationsSource
#1Gianpaolo Perletti (University of Insubria)H-Index: 26
#1Gianpaolo PerlettiH-Index: 1
Last. Vittorio MagriH-Index: 15
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Acute and chronic infections of the prostate gland raise a number of matters of concern to clinicians, due to the difficulties often encountered in diagnosing, treating, and following up these complex diseases. The hindrance to successful eradication of causative pathogens is mainly due to the suboptimal pharmacokinetic properties of available therapeutic agents and to the tissue and cellular obstacles that prevent their efficient delivery to the sites of bacterial infection in the prostate. As ...
#1M. Lindsay Grayson (University of Melbourne)H-Index: 34
#2Nenad MacesicH-Index: 15
Last. Albert G Frauman (University of Melbourne)H-Index: 24
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Editorial Commentary: Fosfomycin: The Current Status of the Drug. Clin Infect Dis. 2015, vol. 61(7) p. 1144-6. doi: 10.1093/cid/civ443
31 CitationsSource