What is it about?
This multicenter observational real-life study describes a cohort of nearly 400 patients treated with intravenous fosfomycin, most of whom were admitted to Critical Care Units. The main indications for treatment included pneumonia (34%), bloodstream infections (22%), and urinary tract infections (21%). Gram-negative bacteria, particularly Escherichia coli and Pseudomonas aeruginosa, were the predominant pathogens. Fosfomycin was administered as empirical therapy in 55% of cases and was almost always used in combination with other antibiotics (99%), most frequently with piperacillin/tazobactam (21%) and newer β-lactam/β-lactamase inhibitor combinations (18%). The median duration of treatment was seven days, and the most common dosing regimen was 16 g/day (65%). 78.7% of isolates showed MIC ≤ 32 mg/L. The 30-, 60-, and 90-day mortality rates were 21.6%, 26.7%, and 29.3%, respectively. This study provides valuable insights into the real-world use of intravenous fosfomycin in severe infections.
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Why is it important?
This study fills a critical gap in real-world data on intravenous fosfomycin use for severe infections, especially in ICU settings.
Perspectives
Future research should focus on standardized dosing, susceptibility testing, and possible monotherapy roles. Ongoing prospective studies like FORTRESS will help define fosfomycin’s place in modern antimicrobial strategies.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: Intravenous Fosfomycin for Difficult-to-Treat Infections: A Real-Life Multicentric Study in Italy, Antibiotics, April 2025, MDPI AG,
DOI: 10.3390/antibiotics14040401.
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