fosfomycin and Streptococcal-Infections

effects of Fosfomycin (FOM) nebulizer therapy were studied in patients with chronic sinusitis.. about 28 patients with chronic sinusitis were administered 2 ml of FOM sodium (3% w/v) by nebulizer three times per week for 4 weeks. Levels of IL-1 beta, IL-6, IL-8, and TNF-alpha in nasal lavage were also measured before and at the end of treatment.. the overall efficacy of this treatment on the basis of both subjective and objective symptoms, was 'excellent' for 28.6%, 'good' for 10.7%, 'fair' for 39.4%, and yield 'no change' for 21.4% of the patients. Both IL-1 beta and IL-6 concentrations were significantly decreased after treatment. Although the IL-8 level did not significantly decrease, it seems to be related to the overall efficacy. TNF-alpha was not detected in all of the samples.. FOM nebulization therapy is highly effective in treatment for chronic sinusitis, and efficacy may be due to an immunomodulatory mechanism, as well as its bactericidal effect.

Topics: Adolescent; Adult; Aged; Child; Chronic Disease; Drug Administration Schedule; Exudates and Transudates; Female; Fosfomycin; Haemophilus Infections; Humans; Interleukins; Male; Middle Aged; Nebulizers and Vaporizers; Sinusitis; Streptococcal Infections; Treatment Outcome; Tumor Necrosis Factor-alpha

To determine the antimicrobial activity against streptococcal biofilm in species mostly isolated from implant-associated infections and examine the effect of enzyme treatment of biofilm on the antimicrobial activity of different antibiotics.. The activities of fosfomycin, rifampicin, benzylpenicillin, daptomycin, gentamicin, levofloxacin, proteinase K and their combinations on planktonic and/or biofilm-embedded standard laboratory strains of Streptococcus agalactiae, Streptococcus pyogenes and Streptococcus oralis were investigated in vitro by standard methods and isothermal microcalorimetry.. MIC values obtained for the tested antimicrobials against planktonic bacteria ranged from 0.016 to 128 mg/L for the three species tested. Higher antibiotic concentrations were usually required to reduce biofilm in comparison with planktonic bacteria, with the exception of gentamicin, for which similar concentrations (4-16 mg/L) exerted an effect on both planktonic and biofilm cells. A synergistic effect against the streptococcal biofilm of the three species was observed when gentamicin was combined with benzylpenicillin or with rifampicin. Moreover, antibiotic concentrations comparable to the MIC observed against planktonic cells induced a strong reduction of viable bacteria in proteinase K pre-treated biofilm.. This study shows that the combination of gentamicin with either benzylpenicillin or rifampicin exerts a synergistic effect against biofilms produced by the tested streptococci strains in vitro. Our results also suggest that coupling a dispersal agent with conventional antibiotics may facilitate their access to the bacteria within the biofilm. In vivo and clinical studies are needed in order to confirm whether such a strategy may be effective in the treatment of implant-associated infections caused by streptococci.

Topics: Anti-Bacterial Agents; Biofilms; Calorimetry; Daptomycin; Fosfomycin; Gentamicins; Humans; Microbial Sensitivity Tests; Microbial Viability; Plankton; Streptococcal Infections; Streptococcus agalactiae; Streptococcus oralis; Streptococcus pyogenes

Acute osteomyelitis of the clavicle accounts for less than 3% of osteomyelitis cases, with its usual location in the middle third. It may be hematogenous, due to contiguity, or secondary to catheterization of the subclavian vein or neck surgery. The diagnosis is often delayed, and clinical symptoms may simulate obstetric brachial plexus palsy in young children. We report a new case of osteomyelitis of the clavicle in a 30-day-old newborn.

Topics: Abscess; Administration, Oral; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Catheterization, Central Venous; Cefotaxime; Clavicle; Female; Fever of Unknown Origin; Follow-Up Studies; Fosfomycin; Fractures, Spontaneous; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Infusions, Intravenous; Male; Osteomyelitis; Pregnancy; Pregnancy Complications, Infectious; Radionuclide Imaging; Sepsis; Streptococcal Infections; Ultrasonography

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Infectious; Cephalosporins; Diagnosis, Differential; Female; Fosfomycin; Humans; Pregnancy; Pubic Symphysis; Puerperal Disorders; Streptococcal Infections

A 5-year-old girl was hospitalised for fever, abdominal and lumbar pain, associated with general impairment state and a whitlow. One of the blood cultures and CSF grew A beta haemolytic Streptococcus, muscular echography and MRI showed paravertebral myositis, which was complicated by an epidural abscess. The outcome was good with medical treatment alone.. Streptococcal myositis is a rare and severe skeletal muscle infection caused by A beta haemolytic Streptococcus. It is characterized by a muscle necrosis, without abscess formation. It has to be distinguished from pyomyositis, usually caused by Staphylococcus aureus, where a muscle abscess occurs, which must be treated by surgical drainage and antibiotics. Prognosis of this infection is poorer than other muscle infections such as pyomyositis, with a high mortality rate. The diagnosis is difficult and often delayed. Practitioners should keep in mind this diagnosis, even if symptoms are non specific, in front of an undetermined infectious syndrome associated with pain, and make an echography or nuclear magnetic resonance imaging to confirm the diagnosis.

Topics: Administration, Oral; Amoxicillin; Anti-Bacterial Agents; Cefotaxime; Child, Preschool; Drug Therapy, Combination; Epidural Abscess; Female; Follow-Up Studies; Fosfomycin; Humans; Magnetic Resonance Imaging; Myositis; Streptococcal Infections; Streptococcus pyogenes; Time Factors; Treatment Outcome; Ultrasonography

Varicella is a common viral infection which is generally benign in infancy and has a good outcome. It may sometimes be complicated by severe group A streptococcal superinfection.. Three days after the beginning of varicella, a previously healthy 2-year-old girl presented with left leg pain, lameness and edema of all four limbs. Toxic shock syndrome occurred, due to beta-hemolytic group A Streptococcus grown from blood culture. Computerized tomography (CT) scan showed a mild effusion involving both hips. Cefotaxim was administered, but the week after magnetic resonance imaging (MRI) showed a necrotizing fasciitis and a lesion of the left leg leading to a patchy femoral diaphysis consistent with osteomyelitis. Joint aspirate culture did not grow. The left leg was immobilized in plaster for 6 weeks and the child was given cefotaxim and fosfomycin parenterally during 30 days, then followed by 45 days of oral amoxicillin. She recovered without sequelae.. Group A Streptococcus infection is a dangerous complication of varicella. It must be considered in case of any joint pain occurring during or just after this disease. The choice of the best treatment needs full collaboration between surgeons, radiologists and pediatricians.

Topics: Cefotaxime; Chickenpox; Child, Preschool; Drug Therapy, Combination; Female; Fosfomycin; Humans; Shock, Septic; Streptococcal Infections; Streptococcus pyogenes

Fosfomycin is an antibacterial substance of low molecular weight and negligible binding to plasma proteins exhibiting in-vitro activity against most pathogens involved in bacterial meningitis including pneumococci. Due to these properties the drug has been recommended for therapy of central nervous system (CNS) infections. For this reason, fosfomycin at doses of 10, 40, 80 and 160 mg/kg/h iv, was investigated in the rabbit model of pneumococcal meningitis. Bacterial counts in cerebrospinal fluid (CSF) before, and 2, 5 and 8 h after initiation of therapy were quantitated by plating on blood agar. Fosfomycin concentrations in serum and CSF were determined by the agar well diffusion method. The MIC and MBC of fosfomycin for the Streptococcus pneumoniae type 3 strain used was 4 and 32 mg/L, respectively. The MIC of ceftriaxone was 0.016 mg/L. In vitro, both drugs showed an additive effect (fractional inhibitory concentration index = 0.75). In vivo at each dose tested, fosfomycin was less active than ceftriaxone (means +/- S.D.): delta log cfu/mL/h at 10 mg/kg/h + 0.130 +/- 0.062 (n = 2), at 40 mg/kg/h -0.217 +/- 0.185 (n = 3), at 80 mg/kg/h -0.270 +/- 0.121 (n = 3), at 160 mg/kg/h -0.331 +/- 0.118 (n = 3) vs -0.647 +/- 0.193 at 10 mg/kg/h ceftriaxone (n = 3). CSF penetration of fosfomycin as estimated by the CSF-to-serum concentration ratio at 8 h was 0.55 +/- 0.22 (n = 11). For bactericidal activity CSF concentrations of at least ten times the MIC were necessary. Coadministration of both drugs (1 mg/kg/h ceftriaxone + 40 mg/kg/h fosfomycin) tended to be more active than either drug alone (in-vivo drug interaction = 1.3). In conclusion, fosfomycin at very high doses reduced bacterial counts in CSF. However, fosfomycin CSF concentrations usually observed in patients with meningitis receiving fosfomycin were not bactericidal in this model. At all doses tested the bactericidal rate was lower than that of ceftriaxone. Fosfomycin is therefore unsuitable as a single agent, but may be used as a reserve antibiotic in combination with a newer cephalosporin for pneumococcal meningitis unresponsive to conventional therapy.

Topics: Animals; Anti-Bacterial Agents; Blood Bactericidal Activity; Cerebrospinal Fluid; Disease Models, Animal; Dose-Response Relationship, Drug; Fosfomycin; Glucose-6-Phosphate; Meningitis, Pneumococcal; Microbial Sensitivity Tests; Rabbits; Streptococcal Infections; Streptococcus pneumoniae

The effectiveness of fosfomycin in combination with other antibiotics was studied in vitro and in the treatment of left-sided endocarditis in rabbits caused by S. sanguis, S. faecalis, S. aureus or P. aeruginosa. In vitro combinations of fosfomycin plus penicillin, fosfomycin plus cloxacillin, and fosfomycin plus amikacin were synergistic against the strains tested. In vivo synergism was also demonstrated since fosfomycin combinations produced a greater reduction in the number of CFU/g of vegetations than the administration of one antibiotic alone.

Topics: Animals; Anti-Bacterial Agents; Drug Evaluation, Preclinical; Drug Synergism; Endocarditis, Bacterial; Fosfomycin; Microbial Sensitivity Tests; Pseudomonas Infections; Rabbits; Staphylococcal Infections; Stem Cells; Streptococcal Infections

Topics: Anti-Bacterial Agents; Binding, Competitive; Cephalexin; Drug Combinations; Drug Synergism; Drug Therapy; Enzyme Inhibitors; Escherichia coli Infections; Fosfomycin; Humans; Klebsiella Infections; Proteus Infections; Salmonella Infections; Staphylococcal Infections; Streptococcal Infections

The effectiveness of penicillin G, fosfomycin, and cefoxitin alone and in combination was studied in vitro and in the treatment of left-sided Streptococcus sanguis endocarditis in rabbits. In vitro, the combinations penicillin G plus fosfomycin, penicillin G plus cefoxitin, and fosfomycin plus cefoxitin were synergistic or partially synergistic for S sanguis. Therapy with the combinations was more effective in eradicating the species from cardiac vegetations that was that with each antibiotic used alone.

Topics: Animals; Anti-Bacterial Agents; Cefoxitin; Drug Synergism; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Fosfomycin; Humans; Penicillin G; Rabbits; Streptococcal Infections; Streptococcus sanguis

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: Ampicillin; Anti-Bacterial Agents; Carbenicillin; Cephalosporins; Chloramphenicol; Cloxacillin; Fosfomycin; Gentamicins; Haemophilus Infections; Humans; Methicillin; Penicillin G; Polymyxins; Pseudomonas Infections; Respiratory Tract Infections; Sepsis; Staphylococcal Infections; Streptococcal Infections