Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
J Glob Antimicrob Resist. 2023 Jun;33:171-176. doi: 10.1016/j.jgar.2023.03.010. Epub 2023 Apr 6.
Data on the use of intravenous (IV) fosfomycin in Canada are limited. Using data captured by the Canadian LEadership on Antimicrobial Real-life usage (CLEAR) registry, we report the use of IV fosfomycin in Canadian patients.
The CLEAR registry uses the web-based data management program, REDCap (https://rcsurvey.radyfhs.umanitoba.ca/surveys/?s=F7JXNDFXEF) to facilitate clinicians' entering of details associated with their clinical experiences using IV fosfomycin.
Data were available for 59 patients treated with IV fosfomycin. The most common infections treated were: bacteraemia or sepsis (25.4% of patients), complicated urinary tract infection (20.3%), ventilator-associated bacterial pneumonia (18.6%), and hospital-acquired pneumonia (13.6%). IV fosfomycin was used to treat Gram-negative (88.1%) and Gram-positive (10.2%) infections. The most common pathogens treated were carbapenem-resistant Enterobacterales (44.1%), multidrug-resistant Pseudomonas aeruginosa (18.6%), vancomycin-resistant Enterococcus faecium (5.1%), and methicillin-resistant Staphylococcus aureus (3.4%). IV fosfomycin was primarily used due to resistance to initially prescribed therapies (69.5%), frequently in combination with other agents (86.4%). Microbiological success (eradication/presumed eradication) occurred in 77.4% of patients, and clinical success (clinical cure/improvement) occurred in 62.5%. Overall, 15.3% of patients died because of their infection. Adverse effects were not documented in 73.1% of patients, and no patient discontinued therapy because of an adverse effect.
In Canada, IV fosfomycin is used primarily as directed therapy to treat a variety of severe infections caused by Gram-negative and Gram-positive bacteria. It is primarily used in patients infected with bacteria resistant to other agents and as part of combination therapy. Its use is associated with relatively high microbiological and clinical cure rates, and it has an excellent safety profile.
加拿大静脉注射（IV）磷霉素的数据有限。我们利用加拿大抗菌药物实际应用领导力（CLEAR）登记处捕获的数据，报告加拿大患者使用 IV 磷霉素的情况。
CLEAR 登记处使用基于网络的数据管理程序 REDCap（https://rcsurvey.radyfhs.umanitoba.ca/surveys/?s=F7JXNDFXEF），便于临床医生输入与他们使用 IV 磷霉素的临床经验相关的详细信息。
共 59 例接受 IV 磷霉素治疗的患者的数据可用。治疗的最常见感染包括：菌血症或败血症（25.4%的患者）、复杂尿路感染（20.3%）、呼吸机相关性细菌性肺炎（18.6%）和医院获得性肺炎（13.6%）。IV 磷霉素用于治疗革兰氏阴性（88.1%）和革兰氏阳性（10.2%）感染。治疗的最常见病原体包括耐碳青霉烯类肠杆菌科（44.1%）、多药耐药铜绿假单胞菌（18.6%）、万古霉素耐药粪肠球菌（5.1%）和耐甲氧西林金黄色葡萄球菌（3.4%）。IV 磷霉素主要由于最初治疗方案的耐药性而使用（69.5%），经常与其他药物联合使用（86.4%）。77.4%的患者微生物学疗效（清除/假定清除），62.5%的患者临床疗效（临床治愈/改善）。总体而言，15.3%的患者因感染而死亡。73.1%的患者未记录不良反应，无患者因不良反应而停止治疗。
在加拿大，IV 磷霉素主要作为定向治疗药物，用于治疗由革兰氏阴性和革兰氏阳性细菌引起的各种严重感染。它主要用于感染对其他药物耐药的细菌的患者，以及作为联合治疗的一部分。它的使用与相对较高的微生物学和临床治愈率相关，且具有极好的安全性。
