ArticleBMC infectious diseases2024
Adverse events during intravenous fosfomycin therapy in a real-life scenario. Risk factors and the potential role of therapeutic drug monitoring.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed.
- Real-World Data on the Use of Intravenous Fosfomycin for the Treatment of Central Nervous System Infections: a Subgroup Analysis from the FORTRESS Study.Infectious diseases and therapy · 2026Article
- Fosfomycin Use in Treating Severe Difficult-to-Treat Gram-Negative Infections-A Comprehensive Review.Antibiotics (Basel, Switzerland) · 2026Review
- Neurotoxicity of Broad-Spectrum Antibiotics in Urinary Tract Infections: Mechanisms and Clinical Implications.Advances in urology · 2026Review
- Efficacy and Safety of Fosfomycin Disodium in Patients with Bacterial Infections: A Single-Center, Real-Life Clinical Study.Journal of clinical medicine · 2025Article
- Population pharmacokinetics of intravenous fosfomycin: dose optimization for critically ill patients with and without kidney replacement therapy.Antimicrobial agents and chemotherapy · 2025Observational
- Monitoring Plasma Concentrations of Intravenously Administered Fosfomycin to Prevent Drug-Related Adverse Events: A Retrospective Observational Study.Antibiotics (Basel, Switzerland) · 2025Article
- Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study.Infectious diseases and therapy · 2025Article
- Could a Reduced Dose of 8 g of Continuous Infusion Fosfomycin Be Considered as Effective as and Safer than a Standard 16 g Dose When Combined with High-Dose Daptomycin in the Treatment ofAntibiotics (Basel, Switzerland) · 2025Article
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15 authors.
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Abstract
backgroundIntravenous fosfomycin (IVFOF) is gaining interest in severe infections. Its use may be limited by adverse events (AEs). Little experience exists on IVFOF therapeutic drug monitoring (TDM) in real-life setting. PATIENTS AND
methodsRetrospective study of patients receiving IVFOF for > 48 h at Policlinico Hospital (Milan, Italy) from 01/01/2019 to 01/01/2023. AEs associated to IVFOF graded CTCAE ≥ II were considered. Demographic and clinical risk factors for IVFOF-related AEs were analysed with simple and multivariable regression models. The determination of IVFOF TDM was made by a rapid ultraperformance liquid chromatography mass spectrometry method (LC-MS/MS) on plasma samples. The performance of TDM (trough levels (Cmin) in intermittent infusion, steady state levels (Css) in continuous infusion) in predicting AEs ≤ 5 days after its assessment was evaluated.
resultsTwo hundred and twenty-four patients were included. At IVFOF initiation, 81/224 (36.2%) patients were in ICU and 35/224 (15.7%) had septic shock. The most frequent infection site was the low respiratory tract (124/224, 55.4%). Ninety-five patients (42.4%) experienced ≥ 1AEs, with median time of 4.0 (2.0-7.0) days from IVFOF initiation. Hypernatremia was the most frequent AE (53/224, 23.7%). Therapy discontinuation due to AEs occurred in 38/224 (17.0%). ICU setting, low respiratory tract infections and septic shock resulted associated with AEs (RR
conclusionsWe provided real world data on the use of IVFOF-based regimens and associated AEs. IVFOF TDM deserves further research as it may represent a valid tool to predict AEs. KEY POINTS: Real world data on intravenous fosfomycin for severe bacterial infections. AEs occurred in over 40% (therapy discontinuation in 17%) and were related to baseline clinical severity but not to fosfomycin dose. TDM showed promising results in predicting AEs.
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