2412. Our Experience With IV Fosfomycin
Session: Poster Abstract Session: Treatment of AMR Infections
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • ID week poster 2018 09-09-18-converted.pdf (398.1 kB)
  • Background: Antimicrobial resistance in gram negative organism is a global problem. There is an increased interest in Fosfomycin due to its attractive PK/PD properties. The present study aimed to examine the effectiveness & safety of IV Fosfomycin which has been recently licensed in India

    Methods: We retrospectively studied patients who received IV Fosfomycin from January 2017 to February 2018. Patients with proven or suspected sepsis given IV Fosfomycin were included in the study. Clinical, microbiological outcome & adverse reactions were noted

    Results: 27 patients received IV fosfomycin. Of these 6 were excluded from the study because 2 had SIRS due to non-infective etiology, 1 had an organism with Fosfomycin resistance & 3 had incomplete clinical records. 7 patients received empirical & 14 received directed treatment. The most frequent isolate was Carbapenem-resistant Klebsiella pneumoniae found in 8 patients. 1 patient received monotherapy while 20 received combination therapy. 9 patients were clinically cured. 1 showed clinical improvement, 8 worsened on treatment due to adverse drug reactions & 3 patients died while on treatment. Microbiological cure was seen in 6 patients. 3 had persistently positive cultures. 1 patient with bacteremic UTI due to Klebsiella pneumoniae received IV fosfomycin for 14 days and relapsed after 1 week of stopping treatment with the same organism showing fosfomycin resistance. 16 patients developed adverse drug reactions. The most common adverse drug reaction was diarrhea in 13, among them 1 had C. difficile colitis. Other adverse reactions like hypernatremia & hypokalemia were observed in 7 & 10 patients respectively. Electrolyte imbalance were seen in patients aged >50 & those who received a higher dose than was appropriate for the creatinine clearance. 2 patients developed non-cardiogenic pulmonary edema within 72 hours of starting fosfomycin & 1 developed torsades de pointes with QT prolongation due to hypokalemia

      

    Conclusion: Fosfomycin appears to be a useful addition to the treatment armamentarium. Although adverse events have not been considered significant in most reviews, they are highly significant in our experience. We recommend careful monitoring of fluid and electrolyte balance in patients receiving IV fosfomycin

    Pratik Savaj, DNB1, Kanishka Davda, DNB1, Ayesha Sunavala, FNB2 and Rajeev Soman, MD, FIDSA1, (1)PD Hinduja National Hospital and Medical Research Centre, Mumbai, India, (2)PD Hinduja National Hospital and Medical Research Centre, Mumbai, India, Mumbai, India

    Disclosures:

    P. Savaj, None

    K. Davda, None

    A. Sunavala, None

    R. Soman, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.