Fosfomycin for management of persistent female lower urinary tract infection
Abstract
We would like to make a commentary and share experience on the previous issue raised by Sultan et al.[1] Sultan et al. performed in vitro study and concluded that “Fosfomycin has emerged as a promising option, especially in cases involving multi-drug-resistant pathogens in which previous antibiotics have failed to cure the infection.”[1] In fact, it is no doubt that persistent female lower urinary tract infection is a very important problem in urology and this is considered a “major socioeconomic problem.”[2] Here, the authors have a case of an elderly Thai female who get many antibiotics (penicillin, co-trimoxazole and levofloxacin) for treatment of chronic osteomyelitis for about 2 years and she also has persistent lower urinary tract infection with several acute attack episodes. This patient also has underlying poorly controlled diabetes mellitus. Within the past 1 year, she got 6 acute attacks, and the use of standard intravenous cephalosphorin treatment could not clear the bacteriuria. The urine culture showed the extended-spectrum β-lactamase-producing Escherichia coli (FOREST). The case was referred to the infectious medicine specialist, and the patient was finally prescribed for single dose fosfomycin therapy. Of interest, clearance of the persistent bacteriuria could be seen within 1 week. The negative urine culture was also detected. This case can confirm the dramatic therapeutic effect of oral fosfomycin for persistent female lower urinary tract infection. Of…
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