fosfomycin and Enteritis

Because Campylobacter jejuni is most frequently identified as a causative organism of bacterial enteritis in pediatrics, a study was done to evaluate the clinical efficacy against Campylobacter enteritis and the safety of a macrolide antibiotic, rokitamycin (RKM). In case of acute enteritis, RKM was used in a form of dry syrup at a dose level of approximately 30 mg (in potency)/kg body weight and its efficacy and safety were compared to those of fosfomycin (FOM) dry syrup which is currently in use at a dose level of 60 mg (in potency)/kg. Both drugs were administered, as a rule, in 3 divided daily dose (RKM before meal and FOM after meal) for 5 consecutive days. Comparisons of the drugs were made using a well-controlled method. Obtained results are summarized as follows. 1. No significant differences in background factors of the 2 drug groups were apparent, hence it was deemed that no obstacles existed in making comparative studies of the 2 groups with regard to their efficacies and safeties. 2. Overall efficacy rate against Campylobacter enteritis was 100% in the RKM group with a rate of excellent efficacy of 91.3% and the former was 94.4% in the FOM group with the latter of 72.2%. Though the RKM group apparently showed higher rates by 5.6% and 19.1%, respectively, for overall and excellent efficacies, they were not statistically significant as both drugs showed good efficacies. When acute cases of enteritis other than those caused by Campylobacter were included in the analysis, overall efficacy rates and rates of excellent efficacy were, respectively, 97.6% and 85.7% for the RKM group and 88.6% and 68.2% for the FOM group, thus RKM showed higher efficacy rates by 9.0% and 17.5%, respectively. These differences were deemed statistically significant using the U-test. 3. Numbers of days required for most of the major symptoms to subside were 3 days or less for the group for which RKM was used against Campylobacter enteritis. Similar results were observed for the FOM group also. In cases of acute enteritis due to other causes than Campylobacter, slower recoveries were observed for both the RKM and the FOM groups than in Campylobacter enteritis cases, with the latter group slower than the former. In cases of puruloid stool, the recovery in the RKM group was significantly faster by U-test than the FOM group, and a similar trend was observed overall. 4. Bacteriologically, the eradication rate of Campylobacter in the RKM group was very good at 91.3% with the FO

Topics: Acute Disease; Administration, Oral; Age Factors; Campylobacter fetus; Campylobacter Infections; Child; Child, Preschool; Clinical Trials as Topic; Dosage Forms; Enteritis; Female; Fosfomycin; Humans; Infant; Male; Miocamycin; Multicenter Studies as Topic

Forty-three children and 4 adults with Campylobacter enteritis were studied in the treatment of fosfomycin (FOM). FOM was administered per orally in doses ranging from 50 to 100 mg/kg/day for children and 3 g/day for adults for 5 days. Main symptoms such as diarrhea and fever were disappeared within 2 days on the average. Campylobacter jejuni in stool specimen disappeared within a week in 95% of these patients. The duration of main symptoms and the period of positive stool culture were evidently shortened in FOM-treated group compared with non-treated group. All of the isolated strains were sensitive to FOM by mono-concentration disk method. MIC50 of these strains remained between 1.56 and 3.13 micrograms/ml. None of these MIC was beyond 12.5 micrograms/ml.

Topics: Administration, Oral; Adolescent; Adult; Aged; Anti-Bacterial Agents; Campylobacter fetus; Campylobacter Infections; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Enteritis; Fosfomycin; Humans; Infant; Middle Aged

We report 2 cases of recurrent Campylobacter coli enteritis caused by macrolide- and fluoroquinolone-resistant strains in 2 patients with hypogammaglobulinemia, successfully treated with a prolonged course of fosfomycin-tromethamine with no side effects. Fosfomycin-tromethamine may be a feasible alternative therapy for recurrent enteritis caused by Campylobacter species resistant to first-line drugs.

Topics: Agammaglobulinemia; Aged, 80 and over; Anti-Bacterial Agents; Campylobacter; Enteritis; Female; Fosfomycin; Humans; Microbial Sensitivity Tests; Middle Aged; Tromethamine

The in vitro antibacterial activities of fosfomycin (FOM) and 3 fluoroquinolones against Salmonella spp., pathogenic Escherichia coli, Campylobacter spp. and Shigella spp. were investigated. The activity upon the environmental condition in the inflammation was compared with standard condition in vitro. On standard condition, the MIC90 of tosfloxacin (TFLX), norfloxacin (NFLX) and levofloxacin (LVFX) against E. coli (77 strains), Shigella spp. (50) and Salmonella spp. (41) were < or = 0.025-0.10, 0.10, and 0.05 microgram/ml, respectively. The MIC90 of FOM against those organisms was 0.39-1.56 micrograms/ml. The MIC90 of TFLX, NFLX, LVFX against Campylobacter spp. were 6.25, 100 and 3.13 micrograms/ml, respectively. The MIC90 of FOM was 50 micrograms/ml. The activity of FOM was unaffected by pH and in anaerobic condition. On the other hand, the activity of NFLX was decreased in low pH and in anaerobic condition. In the presence of horse blood and addition of Na+, the activities of both agents were unaffected. These results suggested that FOM is equally active with or superior to fluoroquinolone in the intestinal infection treatment.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Infections; Blood; Campylobacter; Electrolytes; Enteritis; Escherichia coli; Escherichia coli O157; Fosfomycin; Humans; Hydrogen-Ion Concentration; Levofloxacin; Microbial Sensitivity Tests; Norfloxacin; Ofloxacin; Salmonella; Shigella

The drug susceptibility patterns were investigated for verotoxin-producing Escherichia coli (VTEC) including O-157, Salmonella spp., Vibrio parahaemolyticus and Campylobacter jejuni subsp. jejuni that were obtained in and after July 1996. The results are summarized as follows; 1. We found highly resistant strains of VTEC to tetracycline (TC) and ampicillin (ABPC). Minimum inhibitory concentrations (MIC) of some of the drugs against VTEC in an aerobic condition were significantly different from those in an anaerobic condition. For example, aerobic.anaerobic MIC ranges of the drugs tested were as follows: chroramphenicol (CP): 1.56-3.13 micrograms/ml.0.78-1.56 micrograms/ml, TC: 1.56-> 100 micrograms/ml.0.78-> 100 micrograms/ml, minocycline (MINO): 1.56-12.5 micrograms/ml.0.78-3.13 micrograms/ml, kanamycin (KM): 3.13-6.25 micrograms/ml.25-100 micrograms/ml, fosfomycin (FOM): 3.13-25 micrograms/ml.0.78-6.25 micrograms/ml, norfloxacin (NFLX): < or = 0.025-0.2 microgram/ml.< or = 0.025-0.2 microgram/ml, ABPC: 1.56-> 100 micrograms/ml.0.78-> 100 micrograms/ml and cefaclor (CCL): 1.56-25 micrograms/ml.56-12.5 micrograms/ml. MICs of CP and tetracyclines (TCs) in an anaerobic condition were lower by twofold and the MIC of FOM was lower by fourfold, but the variabilities of MIC-ranges of NFLX, ABPC and CCL were small. The MIC of KM was high. 2. We observed that some of Salmonella spp. were highly resistant to CP, TCs and MINO, and some were moderately resistant to NFLX. 3. The detection frequency of TC-resistant strains and NFLX-insensitive or resistant strains were high among C. jejuni subsp. jejuni. 4. Strains of V. parahaemolyticus and C. jejuni subsp. jejuni were mostly resistant to ABPC and CCL, MICs of which were in high ranges. 5. Fecal concentrations in MINO, KM, FOM and NFLX reported in literatures are high enough to have some antimicrobial activities, leed dose of ABPC and CCL are quite low.

Topics: Aerobiosis; Ampicillin; Anaerobiosis; Anti-Bacterial Agents; Anti-Infective Agents; Campylobacter jejuni; Cefaclor; Cephalosporins; Chloramphenicol; Drug Resistance, Microbial; Enteritis; Escherichia coli O157; Fosfomycin; Humans; Microbial Sensitivity Tests; Minocycline; Norfloxacin; Penicillins; Salmonella; Tetracycline; Vibrio parahaemolyticus

Out of 1,219 pediatric patients who were brought to our hospital with chief complaint of diarrhea and abdominal pain and in whom stool cultures were obtained for bacteriological studies in the 17 month period from May 1 in 1981 to September 30 in 1982, Campylobacter jejuni was isolated in 203 patients (16.7%). In this study we assessed the efficacy of fosfomycin (FOM) for C. jejuni enteritis. Results of antibiotic susceptibility tests revealed that C. jejuni is highly sensitive to FOM. The efficacy of FOM was confirmed both clinically and bacteriologically. Moreover, improvement in diarrheal symptoms and the duration required for cultural conversion under FOM treatment were assessed. From the results obtained, it was considered that FOM is an antibiotic with high efficacy for the treatment of C. jejuni enteritis.

Topics: Adolescent; Anti-Bacterial Agents; Campylobacter fetus; Campylobacter Infections; Child; Child, Preschool; Drug Evaluation; Drug Resistance, Microbial; Enteritis; Female; Fosfomycin; Humans; Infant; Male

Topics: Abscess; Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacterial Infections; Child; Drug Evaluation; Enteritis; Female; Fosfomycin; Humans; Male; Meningitis; Middle Aged; Respiratory Tract Infections; Urinary Tract Infections

The Japan Research Committee of Fosfomycin was organized in the fall of 1972 to promote the basic and clinical studies on fosfomycin. First of all, a subcommittee of fosfomycin consisting of a limited number of members was organized to establish the methods of determination on its antibacterial activity and its concentration in the biological fluid, and the most applicable methods were devised. The clinical trials on its oral form in a small scale were commenced from spring in 1973, and then gradually expanded to almost all of Japan. The clinical trials on its parenteral intravenous form were also undertaken from the latter half of 1973. The basic and clinical results obtained from hospitals and institutes almost all over Japan, to which members of the above Committee belong, were presented by speakers under a hot discussion in two symposia which were held by the Japan Society of Chemotherapy; one on its oral form in June 1974, and another on its parenteral form in December 1974. I served as chairman in both of the symposia. The clinical results of fosfomycin in Japan which were mainly collected in both symposia are described below. Its antibacterial activity, and absorption and exretion will be presented elsewhere in this volume. Clinical results of its oral form: Dosage forms of fosfomycin-Ca salt, capsule and granules, were prepared for its clinical trials. It resulted effective in about 76% of 1,200 patients with infection due to gram-positive or gram-negative (Pseudomonas, Salmonella, Escherichia coli, etc.) bacteria in several fields. As far as rates of efficacy were concerned, it was more effective in surgical, urological, ophthalmic and some other fields than in internal and pediatric ones. Fosfomycin was given in a dose of 2-3 g/day for adults or 100-130 mg/kg for infants and children in most cases. Furthermore, it can be favorably mentioned that fosfomycin was proved to be effective in salmonellosis and resistant shigellosis by a certain research group specialized in the therapy of infectious enteritis. Clinical results of its parenteral form: Sterlized bulk material of fosfomycin-Na salt was prepared in a vial for clinical use. Similarly as in the case of oral form, it was applied to about 500 patients with several infections. It resulted effective in about 68% of them. This percentage was not as high because of the higher frequency of application to severe patients or patients with underlying disease. Fosfomycin was intravenously administered

Topics: Administration, Oral; Anti-Bacterial Agents; Bacterial Infections; Drug Evaluation; Enteritis; Female; Fosfomycin; Humans; Injections, Intravenous; Respiratory Tract Infections; Urinary Tract Infections

Since fosfomycin has behaved in vitro as a broad-spectrum antibiotic, an attempt has been made to evaluate this behaviour in controlled clinical study carried out at different Spanish hospitals. A total of 959 patients were treated for some of the following infectious clinical processes: gonococcal urethritis, typhoid fever, enterocolitis, acute and chronic urinary tract infections, osteomyelitis, chronic otorrhoea, septicaemia, meningitis, peritonitis, surgical and suppurative infections, bronchitis, pneumonia, pharyngoamygdalitis, burns, endometritis, ocular infection, whooping cough and nasal carriers of S. aureus. The results obtained as a function of the microorganism isolated in these clinical processes in percentage of clinical and bacteriological success have been 96% of the S. aureus infections, 95% of the Streptococcus sp. including S. pneumoniae, 90% of the N. gonorrhoeae infections, 94% of the E. coli infections including enteropathogenic E. coli, 90% of the S. marcescens infections, 76% of the Proteus sp. infections, 72% of the Klebsiella-Enterobacter infections, 66% of P. aeruginosa infections and 78% of the S. typhi infections.

Topics: Anti-Bacterial Agents; Bacterial Infections; Drug Evaluation; Enteritis; Enterobacteriaceae Infections; Fosfomycin; Humans; Respiratory Tract Infections; Staphylococcal Infections; Streptococcal Infections; Urinary Tract Infections

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Dosage Forms; Enteritis; Escherichia coli; Female; Fosfomycin; Humans; Infant; Male; Salmonella Infections; Staphylococcus; Urinary Tract Infections