López-Montesinos I, Horcajada J P
Juan Pablo Horcajada, Servicio de Enfermedades Infecciosas, Hospital del Mar, Barcelona, Spain.
Rev Esp Quimioter. 2019 May;32 Suppl 1(Suppl 1):37-44.
Urinary tract infections are one of the most common health problems and entail a high consumption of health system resources. Due to the increase in global antibiotic resistances in recent years, it is increasingly common to find uropathogens with multiple resistance mechanisms, including quinolone-resistant bacteria, broad-spectrum β-lactamase producers and carbapenemase producers. In this scenario, the role of fosfomycin has gained considerable importance, given its spectrum of activity against multidrug resistant microorganisms (Gram-positive and Gram-negative), becoming an attractive alternative therapy. Regarding the use of fosfomycin in complicated urinary tract infections, there is increasing clinical experience with patients with infections caused by multidrug resistant bacteria, those with recurrent urinary tract infection and special populations such as those with kidney transplants. Randomized comparative studies and series are underway, which will provide greater evidence. Nevertheless, more studies are needed to confirm the enormous potential of fosfomycin in complicated urinary tract infection in the era of multiresistance.
尿路感染是最常见的健康问题之一，消耗大量卫生系统资源。由于近年来全球抗生素耐药性增加，具有多种耐药机制的尿路病原体越来越常见，包括耐喹诺酮细菌、广谱β-内酰胺酶产生菌和碳青霉烯酶产生菌。在这种情况下，磷霉素的作用变得相当重要，因为它对多重耐药微生物（革兰氏阳性和革兰氏阴性）具有活性谱，成为一种有吸引力的替代疗法。关于磷霉素在复杂性尿路感染中的应用，对于由多重耐药菌引起感染的患者、复发性尿路感染患者以及肾移植等特殊人群，临床经验越来越多。随机对照研究和系列研究正在进行中，将提供更多证据。然而，仍需要更多研究来证实磷霉素在多重耐药时代对复杂性尿路感染的巨大潜力。
