A study on the efficacy and safety of fosfomycin for the treatment of Multidrug-Resistant Enterobacterales urinary tract infection in North Indian type 2 diabetes mellitus patients.

INTRODUCTION

The incidence of multidrug-resistant Enterobacterales (MDRE) associated urinary tract infection (UTI) in patients with diabetes mellitus is increasing and it is associated with poor prognosis. Due to antibiotic resistance, re-emerging antibiotics like fosfomycin are garnering interest.

OBJECTIVES

This study examined the effectiveness and safety of oral fosfomycin in treating MDRE related UTIs in patients with diabetes mellitus at a tertiary care centre in North India. It also studied MDRE infection risk factors present in the local population.

METHOD: Seventy-three type 2 diabetes mellitus patients were recruited in this single-centre, single-arm prospective interventional study. Oral fosfomycin was tested for clinical & microbiological efficacy, and its safety profile was also assessed. Antimicrobial susceptibility and prevalence profile of uropathogens in study population was also determined.

RESULTS

The average patient age was 54.32 years, with 68.49 % female. E. coli (42.4 %) and Klebsiella (31.5 %) were the most prevalent pathogens. Clinical improvement was achieved in 91 % men and in 98 % women, while microbiological improvement was noted in 82.6 % males and in 90 % for females. Overall, 78.1 % of patients recovered both clinically and microbiologically. Fosfomycin was well tolerated in general, with minimal side effects.

CONCLUSION

Fosfomycin appears to be an effective and well-tolerated therapeutic option for type 2 diabetes mellitus patients with MDRE UTIs in our study, although larger comparative studies are needed.