ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Adjunctive Fosfomycin for the Treatment of Staphylococcus aureus Bacteremia: A Pooled Post Hoc Analysis of Individual Participant Data From 2 Randomized Trials.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06695832 (Adjunctive Fosfomycin for Treatment of Staphylococcus Aureus Bacteraemia), which is not on this map. Cited by 2 papers.
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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.
Adjunctive Fosfomycin for Treatment of Staphylococcus Aureus Bacteraemia: Protocol for a Pooled Post-hoc Analysis of Two Randomised Clinical Trials
Who cites it
2 citing papers in PubMed.
- Subphenotype- and complication-guided adjunctive fosfomycin versus standard monotherapy inThe Lancet regional health. Europe · 2026Article
- Intravenous Fosfomycin for Gram-Negative and Gram-Positive Bacterial Infections: A Systematic Review of the Clinical Evidence.Antibiotics (Basel, Switzerland) · 2025Review
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11 authors.
Funding
Abstract
backgroundThe role of adjunctive fosfomycin in Staphylococcus aureus bacteremia (SAB) remains uncertain.
methodsWe performed a post hoc pooled analysis of individual participant data from the multicenter BACSARM and SAFO randomized controlled trials, which assessed fosfomycin combined with daptomycin or cloxacillin versus monotherapy for methicillin-resistant and methicillin-susceptible SAB. The primary outcome was treatment success at 8 weeks, defined as the patient being alive, without signs of relapse, and showing resolution of fever and improvement in clinical signs and symptoms of infection. Secondary outcomes included persistent bacteremia at days 3 and 7; all-cause mortality at days 14, 30, and 60; and adverse events leading to treatment discontinuation. Bayesian and frequentist methods were used to estimate treatment effects, with the primary Bayesian analysis using a minimally informative prior centered on no treatment effect.
resultsThe intention-to-treat population comprised 369 participants, of whom 178 received fosfomycin combination therapy and 191 received monotherapy. The primary Bayesian analysis showed a 91.8% posterior probability that fosfomycin improves treatment success at 8 weeks (median relative risk [RR], 1.10 [95% credible interval {Crl}, .97-1.26]) with sensitivity analyses (using pessimistic, skeptical, and optimistic priors) yielding probabilities between 75.8% and 97.2%. Fosfomycin was associated with a significant reduction in persistent bacteremia at day 3 (median RR, 0.19 [95% CrI, .07-.41]) and day 7 (median RR, 0.22 [95% CrI, .03-.84]). The adjusted frequentist analysis demonstrated an association between fosfomycin combination therapy and treatment success at 8 weeks (RR, 1.04 [95% confidence interval {CI}, 1.02-1.06]; P < .001). Combination therapy was associated with a higher risk of adverse events (RR, 2.03 [95% CI, 1.13-3.63]; P = .017).
conclusionsAdjunctive fosfomycin may improve early bacterial clearance and treatment success in SAB but at the cost of increased toxicity. Clinical Trials Registration. NCT06695832.
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