2026-06-08T14:41:04Zhttps://docta.ucm.es/rest/oai/request
oai:docta.ucm.es:20.500.14352/1307872026-01-23T01:26:13Zcom_20.500.14352_14col_20.500.14352_15
Docta Complutense author Ruiz Ruigómez, María author Fernández Ruiz, Mario author Origüen Sabater, Julia author Candel González, Francisco Javier author Pérez Flores, Isabel María author Pascual Santos, Julio author Andrés Belmonte, Amado author Aguado García, José María author López Medrano, Francisco 2026-01-22T10:06:15Z 2026-01-22T10:06:15Z 2023-05-01 Ruiz-Ruigómez M, Fernández-Ruiz M, Silva JT, Vidal E, Origüen J, Calvo-Cano A, et al. Efficacy and safety of oral fosfomycin for asymptomatic bacteriuria in kidney transplant recipients: results from a Spanish multicenter cohort. Antimicrob Agents Chemother. 2023;95(5):e02267-20. doi:10.1128/AAC.02267-20. 0066-4804 10.1128/AAC.02267-20 https://hdl.handle.net/20.500.14352/130787 1098-6596 https://doi.org/10.1128/aac.02267-20 33558295 https://journals.asm.org/doi/10.1128/aac.02267-20https://pubmed.ncbi.nlm.nih.gov/33558295/ Current guidelines recommend against systematic screening or treating asymptomatic bacteriuria (AB) among kidney transplant (KT) recipients, although the evidence regarding episodes occurring early after transplantation or in the presence of anatomical abnormalities is inconclusive. Oral fosfomycin may constitute a good option for the treatment of post-transplant AB, particularly due to the emergence of multidrug-resistant (MDR) uropathogens. Available clinical evidence supporting its use in this specific setting, however, remains scarce. We performed a retrospective study in 14 Spanish institutions from January 2005 to December 2017. Overall, 137 episodes of AB diagnosed in 133 KT recipients treated with oral fosfomycin (calcium and trometamol salts) with a test-of-cure urine culture within the first 30 days were included. Median time from transplantation to diagnosis was 3.1 months (interquartile range [IQR]: 1.1 - 10.5). Most episodes (96.4% [132/137]) were caused by gram-negative bacteria (GNB), and 56.9% (78/137) were categorized as MDR (extended-spectrum β-lactamase-producing Enterobacterales [20.4%] and carbapenem-resistant GNB [2.9%]). Rate of microbiological failure at month 1 was 40.1% (95% confidence interval [95%CI]: 31.9 - 48.9) for the whole cohort and 42.3% (95%CI: 31.2 - 54.0) for episodes due to MDR pathogens. Previous urinary tract infection (odds ratio [OR]: 2.42; 95%CI: 1.11 - 5.29; P-value = 0.027) and use of fosfomycin as salvage therapy (OR: 8.31; 95%CI: 1.67 - 41.35; P-value = 0.010) were predictors of microbiological failure. No severe treatment-related adverse event were detected. Oral fosfomycin appears to be a suitable and safe alternative for the treatment (if indicated) of AB after KT, including those episodes due to MDR uropathogens. eng Efficacy and Safety of Oral Fosfomycin for Asymptomatic Bacteriuria in Kidney Transplant Recipients: Results from a Spanish Multicenter Cohort journal article 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URL https://docta.ucm.es/bitstreams/5b5ce276-d0f8-4976-a3ad-11385fcfe360/download File MD5 b575f1a239a05c8295e971ed1b410391 245219 application/pdf Antimicob Agents Chemother 2021 - Fosfomicina ITU BA - Q1 - último autor.pdf