Study design (if review, criteria of inclusion for studies)
Retrospective analysis of data captured prospectively
54 patients who received IV fosfomycin
Baseline characteristics in the 12 months prior treatment, lung function, CRP, renal and liver function and electrolytes at start and end of treatment were retrieved.
54 patients received 128 courses of IV fosfomycin in combination with a second antibiotic, resulting in improved FEV1 (0.94L vs 1.24L, p<0.01) and reduced CRP (65mg/L vs 19.3mg/L, p<0.01). Renal function pre- and post-treatment remained stable. 4% (n=5) of courses were complicated with AKI at mid treatment, which resolved at the end of the course. Electrolyte supplementation was required in 18% of cases for potassium and magnesium and 7% for phosphate. Nausea was the most common side effect (48%), but was well controlled with anti-emetics.
Antibiotic regimens including fosfomycin appear to be clinically effective and safe. Fosfomycin should, therefore, be considered as an add-on therapy in patients who failed to respond to initial treatment and with multiple drug allergies.