ArticleInfectious diseases and therapy2025
Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study.
Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02979951 (An International, Multicentre, Non-comparative, Non-interventional, Prospective Clinical Registry to Evaluate the Clinical Outcome and Safety of the Treatment of Severely Infected Patients with Fosfomycin I.v.), which is not on this map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An International, Multicentre, Non-comparative, Non-interventional, Prospective Clinical Registry to Evaluate the Clinical Outcome and Safety of the Treatment of Severely Infected Patients with Fosfomycin I.v.
Who cites it
12 citing papers in PubMed.
- Real-World Data on the Effectiveness and Use of Intravenous Fosfomycin for the Treatment of Difficult-to-Treat Infections Caused by Carbapenem-Resistant Gram-Negative Bacteria-A Subgroup Analysis from the FORTRESS Study.Infectious diseases and therapy · 2026Article
- Genomic features of mecA-harboring Staphylococcus epidermidis infecting an illegally traded rufous-bellied thrush (T. rufiventris).Veterinary research communications · 2026Article
- 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 as an adjunctive agent against carbapenem-resistant Acinetobacter baumannii: an updated narrative review.Infection · 2026Review
- Treatment Options for Metallo-Beta-Lactamase-ProducingInternational journal of molecular sciences · 2026Review
- Fosfomycin Use in Treating Severe Difficult-to-Treat Gram-Negative Infections-A Comprehensive Review.Antibiotics (Basel, Switzerland) · 2026Review
- Reviving Old Antibiotics: New Indications and Therapeutic Perspectives-A Review.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Determinants of Multidrug Resistance Among Gram-Positive Uropathogens in Central Portugal: A 5-Year Retrospective Study.International journal of microbiology · 2026Article
- Treatment of central nervous system infections caused byFrontiers in medicine · 2026Review
- In Vitro Evaluation of Fosfomycin Combinations Against Metallo-β-Lactamase-ProducingAntibiotics (Basel, Switzerland) · 2025Article
- Intravenous Fosfomycin for Gram-Negative and Gram-Positive Bacterial Infections: A Systematic Review of the Clinical Evidence.Antibiotics (Basel, Switzerland) · 2025Review
- Emerging Concepts for the Treatment of Biofilm-Associated Bone and Joint Infections with IV Fosfomycin: A Literature Review.Microorganisms · 2025Review
Corrections and comments
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Authors and funding
32 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionIntravenous fosfomycin (FOS) is a broad-spectrum antibiotic primarily used in combination therapy to treat severe infections caused by both Gram-positive (GP) and Gram-negative (GN) pathogens, including multi-drug resistant (MDR) bacteria. The aim of this study, the largest to date, was to evaluate the effectiveness, safety, usage patterns, and patient characteristics of FOS in a real-world setting.
methodsInterim analysis of an ongoing, prospective, non-interventional, multicentre study in five European countries, involving centres in Germany, Italy, the United Kingdom, Greece, and Austria.
resultsA total of 716 patients were enrolled between January 2017 and November 2023 (mean age: 62.8 years, APACHE II: 18.3, SOFA: 6.7). Main indications for FOS were bacteraemia/sepsis (23.6%), complicated urinary tract infections (18.0%), and bone and joint infections (17.4%). Other indications included hospital-acquired/ventilator-associated pneumonia (11.0%), complicated skin and soft tissue infections (9.1%), bacterial meningitis/central nervous system (CNS) infections (7.8%), and infective endocarditis (6.4%). Most common pathogens identified were Staphylococcus aureus (31.4%, including methicillin-resistant S. aureus), Klebsiella spp. (including K. pneumoniae) (17.2%), Escherichia coli (14.2%), coagulase-negative staphylococci (12.9%), other Enterobacterales (10.9%), and Pseudomonas aeruginosa (8.4%). In 34.6% of patients, an MDR pathogen was involved. Carbapenem resistance (CR) was high in Klebsiella spp. infections (59/123, 48.0%). In most patients, FOS was used in combination therapy (90.2%). The median dose was 15 g/day. Overall, clinical success and clinical response were favourable with 75.3% and 83.4% at the end of FOS treatment. Clinical success rates in infections caused by MDR or CR pathogens were 78.0% and 81.8%, respectively. Microbiological cure was achieved in 82.4% of all patients. Electrolyte imbalances were the most frequently observed adverse drug reactions, while gastrointestinal disorders were rare.
conclusionThe results from this study suggest that FOS is a safe and effective option as combination partner in the treatment of patients with severe infections caused by both GP and GN pathogens, including deep-seated infections and/or involvement of MDR bacteria.
trial registrationClinicalTrials.gov identifier, NCT02979951.
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