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Oral fosfomycin for the treatment of lower urinary tract infections among kidney transplant recipients-Results of a Spanish multicenter cohort

Abstract: Oral fosfomycin may constitute an alternative for the treatment of lower urinary tract infections (UTIs) in kidney transplant recipients (KTRs), particularly in view of recent safety concerns with fluroquinolones. Specific data on the efficacy and safety of fosfomycin in KTR are scarce. We performed a retrospective study in 14 Spanish hospitals including KTRs treated with oral fosfomycin (calcium and trometamol salts) for posttransplant cystitis between January 2005 and December 2017. A total of 133 KTRs developed 143 episodes of cystitis. Most episodes (131 [91.6%]) were produced by gram-negative bacilli (GNB), and 78 (54.5%) were categorized as multidrug resistant (including extended-spectrum ?-lactamase-producing Enterobacteriaceae [14%] or carbapenem-resistant GNB [3.5%]). A median daily dose of 1.5 g of fosfomycin (interquartile range [IQR]: 1.5-2) was administered for a median of 7 days (IQR: 3-10). Clinical cure (remission of UTI-attributable symptoms at the end of therapy) was achieved in 83.9% (120/143) episodes. Among those episodes with follow-up urine culture, microbiological cure at month 1 was achieved in 70.2% (59/84) episodes. Percutaneous nephrostomy was associated with a lower probability of clinical cure (adjusted odds ratio: 10.50; 95% confidence interval: 0.98-112.29; P = 0.052). In conclusion, fosfomycin is an effective orally available alternative for treating cystitis among KTRs.

 Fuente: Am J Transplant . 2020 Feb;20(2):451-462

Editorial: Wiley Periodicals Inc.

 Año de publicación: 2020

Nº de páginas: 12

Tipo de publicación: Artículo de Revista

 DOI: 10.1111/ajt.15614

ISSN: 1600-6135,1600-6143

Url de la publicación: https://doi.org/10.1111/ajt.15614

Autores/as

LÓPEZ MEDRANO, FRANCISCO

TIAGO SILVA, JOSÉ

FERNÁNDEZ RUIZ, MARIO

VIDAL, ELISA

ORIGÜEN, JULIA

CALVO CANO, ANTONIA

LUNA HUERTA, ENRIQUE

MERINO, ESPERANZA

HERNÁNDEZ, DOMINGO

JIRONDA GALLEGOS, CRISTINA

ESCUDERO, ROSA

GIOIA, FRANCESCA

MORENO, ANTONIO

ROCA, CRISTINA

CORDERO, ELISA

JANEIRO, DARÍO

SÁNCHEZ SOBRINO, BEATRIZ

MILAGRO MONTERO, MARÍA

REDONDO, DOLORES

CANDEL, FRANCISCO JAVIER

PÉREZ FLORES, ISABEL

CARLOS ARMIÑANZAS CASTILLO

GONZÁLEZ RICO, CLAUDIA

EMILIO RODRIGO CALABIA

LOECHES, BELÉN

LÓPEZ OLIVA, MARÍA O.

MONTEJO, MIGUEL

LAUZURICA, RICARDO

HORCAJADA, JUAN PABLO

PASCUAL, JULIO

ANDRÉS, AMADO

AGUADO, JOSÉ MARÍA

REIPI

REDINREN

GESITRA-IC/SEIMC