fosfomycin and Diabetes-Mellitus--Type-2

The aim of this study was to evaluate the efficacy of chronic therapy with fosfomycin trometamol (TF) in the treatment and prevention of recurrent, uncomplicated urinary tract infections (NIDDM) in type 2 diabetic women.. The study comprised 45 type 2 diabetes women aged 50-70 years. All patients enrolled into the study suffered from the NIDDM presented with clinical signs of uroinfection and positive urine culture with bacterial uropathogen sensitive to TF. Study period lasted 12 months and during the first 9 months patients were treated with TF. The patients remained under regular medical supervision in diabetic outpatient clinic every 3 months. Efficacy of treatment was proved when both clinical cure and uropathogen eradication were achieved in 3, 6, 9 or 12th month from the study beginning.. The difference in efficiency of fosfomycin treatment after 3 months of the study duration in comparison with duration before study beginning was statistically different (p<0.001). The differences in efficiency of fosfomycin treatment after 6 months of study duration in comparison with time before 3 months were statistically different (p=0.03). There was not statistically differences in efficiency of fosfomycin treatment between the 6th and 9th month of study duration (NS).. Fosfomycin is the safe and effective antimicrobial method to cure and prevent NIDDM.

Topics: Aged; Anti-Bacterial Agents; Diabetes Mellitus, Type 2; Female; Fosfomycin; Humans; Male; Middle Aged; Recurrence; Treatment Outcome; Urinary Tract Infections

A case of osteomyelitis caused by multidrug-resistant (MDR) Pseudomonas aeruginosa is reported.. An 84-year-old Caucasian male with an underlying history of type 2 diabetes, peripheral vascular disease, and coronary artery disease had chronic nonhealing wounds on his right foot. Wound care and a course of intravenous (IV) ertapenem with oral ciprofloxacin were ineffective. His initial wound culture grew Staphylococcus aureus, group G streptococcus and P. aeruginosa; the Pseudomonas was susceptible to multiple agents. The patient eventually required midtarsal amputation and angioplasties to his right leg. Twenty days after the operation, 2 openings were discovered at the surgical site, 1 of which was probed to the bone. He was readmitted 5 weeks after the operation. A repeat wound swab grew MDR P. aeruginosa and Finegoldia magna. The Pseudomonas was susceptible to gentamicin and colistin. The patient had revision of the infected amputation site with the goal of salvaging his right lower limb. The patient developed acute renal failure after 26 days of IV gentamicin, IV ceftriaxone, and oral metronidazole. Additional susceptibility testing was performed to identify alternatives. The bacteria were considered susceptible to IV fosfomycin, the last resort, by our microbiology laboratory. This was combined with ceftolozane/tazobactam followed by meropenem to treat the residual infection. After 2 weeks of IV fosfomycin, the patient's wound improved and further amputation was avoided.. Our case demonstrates that IV fosfomycin may provide an effective salvage therapy when combined with β-lactams for the treatment of severe diabetic foot infection or osteomyelitis caused by MDR P. aeruginosa.

Topics: Aged, 80 and over; Diabetes Mellitus, Type 2; Fosfomycin; Humans; Male; Osteomyelitis; Pseudomonas aeruginosa; Salvage Therapy

The aim of this study was to comprise the efficacy of chronic therapy with fosfomycin, co-trimoxazole and nitrofurantoin in the treatment and prevention of recurrent urinary tract infections (UTI) in type 2 diabetic women.. The study comprised 90 women aged 50-70 years, who suffered from the UTI (isolated bacterial uropathogen sensitive to fosfomycin, co-trimoxazole and nitrofurantoin). Women were divided into 3 groups. Group I comprised patients, who have been treated with fosfomycin, group II with co-tromixazole and group III with nitrofurantoin. Observation period lasted 9 months and for the 6 months patients were treated with antimicrobial agents. Efficacy of antimicrobial treatment was estimated when both clinical cure and bacteriological eradication of uropathogens were achieved.. There were no significant differences in the percentage of patients between study groups, who achieved therapeutic successes after 3 and 6 months of the antimicrobial treatment (NS). Three months after discontinuation of treatment episodes of UTI were observed significantly rarely in group treated with fosfomycin in comparison with the group treated with nitrofurantoin (p = 0.01) and co-trimoxazole (p = 0.02).. Fosfomycin, co-trimoxazole and nitrofurantoin are safe and effective antimicrobial methods to cure and prevent UTI. Fosfomycin is associated with rarely recurrence of UTI than nitrofurantoin and co-trimoxazole in the period without its taking.

Topics: Aged; Anti-Infective Agents, Urinary; Diabetes Mellitus, Type 2; Female; Fosfomycin; Humans; Microbial Sensitivity Tests; Middle Aged; Nitrofurantoin; Secondary Prevention; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination; Urinary Tract Infections; Urine