Fosfomicina LUAR
1g injection
Fosfomicina LUAR is active on methicillin-resistant staphylococci, BLEE- or carbapenemase-producing enterobacteria (such as KPC) and 50% of pseudomonas aeruginosa.
About Fosfomicina LUAR
It contains Fosfomycin sodium as active ingredient, and due to the appearance of strains resistant to conventional antibiotic therapies, it is used in association with other antibiotics, used intravenously.
Fosfomicina LUAR is active on methicillin-resistant staphylococci, BLEE- or carbapenemase-producing enterobacteria (such as KPC) and 50% of pseudomonas aeruginosa. It should always be used in association with another antimicrobial to avoid the emergence of resistant strains.
Consequently, it is compatible with any antimicrobial, presenting synergic or additive activity independently of their mechanisms of action. Fosfomycin is active in meningeal, bone, skin and soft tissue, non-prostatic urinary and pulmonary infections.
Administered intravenously, it has no teratogenic effects, so it can be used in pregnant women. By this route of administration there are no side effects.
Frequently Asked Questions
Fosfomicina LUAR Intravenous Injectable 1 g is presented in boxes containing 10 and 100 vials.
In cases of severe hospital infections, the use of Fosfomycin in association with other antibiotics is essential to avoid the selection of resistant mutants (chromosomal acquired resistance) as much as possible. Associations with penicillins, cephalosporins, aminoglycosides, colistin, vancomycin, are always synergistic and never antagonistic.
Fosfomycin sodium is used in complicated or severe infections caused by germs sensitive to the drug (Enterococcus faecalis, Streptococcus pneumoniae, methicillin-resistant Staphylococcus, Citrobacter spp , Escherichia coli, Haemophilus influenzae, Klebsiella spp, Neisseria meningitidis, Pasteurella spp, Proteus mirabilis, Proteus vulgaris, Providencia stuartii, Pseudomonas spp).
Gram-positive facultative bacteria
Fosfomicina LUAR is very active on methicillin-resistant S.aureus, whether community (CAMRSA) or hospital (HAMRSA). The MIC50 ranges from 1 to 2 mg/L and the MIC90 ranges from 16 to 32 mg/L. Coagulase-negative staphylococci such as S. epidermidis, whether or not they are resistant to methicillin, are sensitive, as are S. haemolyticus and S. hominis, although the latter have somewhat higher MICs. However, S.cohnii, S. warneri, S. capitis and notably S.saprophyticus have elevated MICs, frequently greater than 128 mg/L. The differences in activity of Fosfomycin on different species of coagulase-negative staphylococci are attributed to different permeation capacity.
MICs for pneumococci, viridans group streptococci and S.agalactiae are variable but in the range of sensitivity. The sensitivity of enterococci to Fosfomycin is unpredictable. MICs vary between 2 and >128 mg/L but more than 50% are sensitive.
The activity of Fosfomicina LUAR against Listeria spp and most Corynebacterium spp (except C.striatum) is good. MIC in the sensitivity range has been verified in strains of C.urealyticum, the agent of fouling cystitis in humans, canines, and felines. Nocardia spp isolates are consistently resistant.
Aerobic and facultative Gram-negative bacilli
Enterobacteriaceae are sensitive to Fosfomicina LUAR with MIC between 0.25 and 16 mg/L. It is important to highlight the activity on E.coli, K.pneumoniae, Salmonella spp, Shigella spp. K.oxytoca, Enterobacter spp, Providencia spp, Morganella morganii and Serratia spp, whose MICs range from 16 to 64 mg/L, are less sensitive.
Gram-negative bacteria such as Campylobacter jejunii, Yersinia spp and Vibrio spp, are sensitive to Fosfomycin. Activity on Legionella, Pasteurella and Bartonella is effective although moderate. With respect to non-fermenting Gram-negative bacilli, more than 50-60% of P. aeruginosa isolates are sensitive.
Anaerobes
Fosfomicina LUAR acts on Veillonella spp and Fusobacterium spp, with variable MIC values (0.12 to 32 mg/L), has moderate activity (MIC 16-64 mg/L) on Peptococous spp, Clostridium spp and Prevotella spp.
Activity on multiresistant bacteria in Argentina
Two research papers were recently presented by J M Casellas, the first at the Argentine Congress of Microbiology 2010 and the second at the Congress of the Pan American Association of Infectious Diseases in Punta del Este 2011, in which he showed the activity of Fosfomycin higher than 98% on isolates of E.coli and K.pneumoniae, producers of BLEE and carbapenemases, recovered from different sources in Argentina. It was also observed that more than 50% of multiresistant isolates of P.aeruginosa were sensitive to Fosfomycin, as well as all the strains of MRSA and S.epidermidis tested.
