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Fosfomycin

The following undesirable effects are presented by organ system in accordance with the following gradation of the frequency of their occurrence: very common - more than 10% (≥1/10), frequent - more than 1%, but less than 10% (≥1/100 to <1/10 ), uncommon - more than 0.1%, but less than 1% (≥1/1000 to <1/100), rare - more than 0.01%, but less than 0.1% (≥1/10000 to <1/1000 ), very rare - less than 0.01% (<1/10000, including individual reports), unknown (cannot be estimated based on available data).

Immune system disorders

: rarely - acute hypersensitivity reactions (including anaphylactic shock). If any symptoms of anaphylactic reactions develop, such as dyspnea, hypotension, cyanosis, urticarial rash, severe malaise, it is necessary to discontinue the drug and begin appropriate symptomatic therapy.

Skin and subcutaneous tissue disorders

: uncommon - rash, pruritis, urticaria, exanthema. Skin redness, erythema, frequency unknown - angioedema.

Digestive system disorders

: infrequently - diarrhea, nausea, vomiting, abdominal pain, anorexia, change in taste, loss of appetite, rarely - stomatitis, severe colitis with blood in the stool, pseudomembranous colitis. If patients experience abdominal pain or frequent bowel movements, it is necessary to stop taking the drug and begin appropriate symptomatic therapy.

Disorders of the liver and biliary tract

: often - transient increase in the activity of liver enzymes (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase), infrequently - increased levels of lactate dehydrogenase, bilirubin, rarely - impaired liver function, jaundice, frequency unknown - cholestatic hepatitis. In such cases, patients should be under medical supervision. If any liver dysfunction is detected, it is necessary to stop taking the drug and begin appropriate symptomatic therapy.

Nervous system disorders

: rarely - numbness, headache. Dizziness, decreased sensitivity, frequency unknown - increased fatigue, confusion, convulsions. If seizures develop, it is necessary to stop taking the drug and begin appropriate symptomatic therapy.

Respiratory, thoracic and mediastinal disorders

: infrequently - shortness of breath, rarely - cough, acute attack of bronchial asthma, discomfort in the chest, a feeling of squeezing in the chest.

Blood and lymphatic system disorders

: rarely - leukopenia, anemia, granulocytopenia, eosinophilia, pancytopenia, agranulocytosis or thrombocytopenia. very rarely - aplastic anemia. Therapy must be carried out under the control of the patient's blood count. If any disorders develop, it is necessary to stop taking the drug and begin appropriate symptomatic therapy.

Cardiovascular disorders

: infrequently - thrombophlebitis, rarely - rapid heartbeat, vascular pain, hyperemia.

Renal and urinary tract disorders

: rarely - impaired renal function, edema, increased concentration of urea in the blood, proteinuria.

General and administration site disorders

: infrequently - increased body temperature, pain at the injection site, rarely - phlebitis, thirst, feeling of general malaise.

Laboratory and instrumental data

: rarely - hypernatremia, hypokalemia, electrolyte imbalance.

Magazine archive /
2018 /

The effectiveness of fosfomycin trometamol in acute uncomplicated cystitis

DOI: https://dx.doi.org/10.18565/urology.2018.6.70-75

A.V. Kuzmenko, V.V. Kuzmenko, T.A. Gyaurgiev
Department of Urology (Head – Doctor of Medical Sciences, Associate Professor A.V. Kuzmenko) Voronezh State Medical University named after. N. N. Burdenko”, Voronezh, Russia

Introduction. Acute cystitis is the most common manifestation of uncomplicated urinary tract infection. The choice of an antibacterial drug for the treatment of this disease is determined not only by the spectrum of antimicrobial activity against pathogens, but also by the pharmacokinetics of the drug, which would ensure its high concentrations in urine with a single or double dose, as well as a high safety profile and reasonable cost. One of the drugs whose effectiveness in the treatment of patients with UTI has been proven is fosfomycin, which has been on the pharmaceutical market for a long time and is widely used in urological practice. Given the persistent trend towards a decrease in the sensitivity of uropathogens to antibacterial drugs, there is also a risk of a decrease in the effectiveness of fosfomycin. This necessitates monitoring the resistance of the main pathogens to it. This article presents our experience of using fosfomycin in the treatment of women with acute uncomplicated cystitis. Purpose of the study: to evaluate the effectiveness of fosfomycin trometamol in the treatment of women with acute uncomplicated cystitis. Materials and methods. From September to November 2021, we examined and treated 57 women with acute uncomplicated cystitis aged 19 to 40 years. All patients were prescribed Fosfomycin Esparma (fosfomycin trometamol) once, 1 sachet after urination. Examinations were carried out on the 1st, 3rd and 7th days. Urinary frequency, urgency, nocturia, and pain intensity were assessed. A general urinalysis and bacteriological examination of urine samples with uroculture culture on solid nutrient media were also performed, establishing the type of pathogens, sensitivity to antibiotics and the degree of bacteriuria. Results. When contacted, all patients complained of pain in the projection of the bladder, frequent urination in small portions, and a feeling of discomfort in the urethra. All women were diagnosed with leukocyturia and bacteriuria. By the 3rd day after taking fosfomycin, dysuric symptoms persisted in 22.8% of patients, pain – in 17.5%. In 42% of women, slight leukocyturia remained. Bacteriological analysis of urine did not reveal the growth of pathogens. By the 7th day after the start of therapy, all observations showed normalization of all clinical and laboratory parameters. Conclusion. Considering the wide spectrum of action, low resistance of uropathogenic strains, high level of safety and compliance, based on the results of our study, we recommend the use of fosfomycin as a first-choice drug in the treatment of uncomplicated lower urinary tract infection.

Key words: lower urinary tract infections, acute cystitis, fosfomycin, dysuria

The full text of the article is available in the Doctor's Library

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About the authors / For correspondence

AUTHORIZATION: A. V. Kuzmenko – Doctor of Medical Sciences, Associate Professor, Head. Department of Urology, Federal State Budgetary Educational Institution of Higher Education VSMU named after. N. N. Burdenko, Voronezh, Russia; e-mail

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Fosfomycin

The effectiveness of fosfomycin trometamol in acute uncomplicated cystitis

Literature

About the authors / For correspondence

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