Title : Real-life experience with IV fosfomycin in Canada: Results from the C anadian LE adership on A ntimicrobial R eal-life usage (CLEAR) registry
Abstract:
Objectives: Data on the use of intravenous (IV) fosfomycin in Canada are limited. Using data captured by the C anadian LE adership on A ntimicrobial R eal-life usage ( CLEAR) registry, we report the use of IV fosfomycin in Canadian patients. Methods: The CLEAR registry uses the web-based data management program, REDCap TM ( https://rcsurvey. radyfhs.umanitoba.ca/surveys/?s=F7JXNDFXEF ) to facilitate clinicians’ entering of details associated with their clinical experiences using IV fosfomycin. Results: 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 fos- fomycin was used to treat Gram-negative (88.1%) and Gram-positive (10.2%) infections. The most com- mon pathogens treated were carbapenem-resistant Enterobacterales (44.1%), multidrug-resistant Pseu- domonas 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 (eradica- tion/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. Conclusions: 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.
