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Kurt G Naber - One of the best experts on this subject based on the ideXlab platform.

  • non antibiotic herbal therapy bno 1045 versus antibiotic therapy Fosfomycin Trometamol for the treatment of acute lower uncomplicated urinary tract infections in women a double blind parallel group randomized multicentre non inferiority phase iii trial
    Urologia Internationalis, 2018
    Co-Authors: Florian M E Wagenlehner, Dimitri Abramovsommariva, Martina Holler, Hubert Steindl, Kurt G Naber
    Abstract:

    Introduction: This randomized, controlled, Phase III non-inferiority clinical trial aimed to determine whether herbal therapy with Canephron® N (BNO 1045) is non-inferior to Fosfomycin Trometamol (FT) in treating acute lower uncomplicated urinary tract infections (uUTIs). Materials and Methods: Women aged 18–70 years with typical symptoms of newly diagnosed acute lower uUTIs were randomized to BNO 1045 (n = 325) or FT (n = 334), with corresponding matched placebo. The primary endpoint was the proportion of patients who received additional antibiotics (ABs) to treat uUTIs between Days 1 and 38 ±3. Results: Between Days 1 and 38, 238 (83.5%) patients in the BNO 1045 group and 272 (89.8%) patients in the FT group received no additional ABs. At a 15% non-inferiority margin, BNO 1045 was non-inferior to FT in treating uUTIs (non-AB rate difference: –6.26%; 95% CI –11.99 to –0.53%; 2-sided p = 0.0014). Adverse event rates were similar between groups, with higher rates of gastrointestinal disorders in the FT group and pyelonephritis in the BNO 1045 group. During the trial, no patient died or discontinued due to a treatment-related adverse event. Conclusions: BNO 1045 has the potential to reduce outpatient use of ABs for uUTIs and thus may have a significant impact on antimicrobial stewardship strategies. Trial registration: NCT02639520, EudraCT number 2013-004529-99.

  • Fosfomycin Trometamol in patients with renal insufficiency and in the elderly
    The International Arabic Journal of Antimicrobial Agents, 2012
    Co-Authors: Kurt G Naber, Petra Thomas, Reinhard Funfstuck
    Abstract:

    Single oral dose therapy with Fosfomycin Trometamol (FT) 3 g is recommended inthe treatment of uncomplicated urinary tract infection (UTI) not only in premenopausal,but also in postmenopausal elderly, otherwise healthy women. It can alsobe used as reapplication every 10 days for prophylaxis of recurrent uncomplicatedcystitis. FT 3 g has also been used with two oral doses of 3 g (on two consecutivedays) for perioperative prophylaxis in transurethral interventions or with three doses(every other day, three times) for treatment of complicated lower UTI includingmany elderly patients. The tolerance and safety in the patients above 65 yearsof age did not differ from younger ones. Therefore, there is also an indication toadminister oral FT 3g in adults above 65 years of age for treatment or prophylaxisof uncomplicated UTI.Patients with renal insufficiency up to a creatinine clearance of 20 ml/min can beexpected to have still sufficiently high urinary concentrations of Fosfomycin, thattreatment of cystitis should be justified from pharmacokinetic/pharmacodynamicpoint of view. From preliminary clinical results there is also an indication to useoral FT 3 g in adults with renal insufficiency up to a creatinine clearance of 20 ml/min, with single dose for treatment of lower uncomplicated UTI with otherwisenormal urinary tract or with repeated doses (every second or third day accordingto the degree of renal insufficiency) for treatment of lower complicated UTI causedby Fosfomycin susceptible pathogens resistant to other oral antimicrobial drugs.

  • spectrum and susceptibility of pathogens causing acute uncomplicated lower uti in females and its correlation to bacteriologic outcome after single dose therapy with Fosfomycin Trometamol versus ofloxacin co trimoxazole
    Infection, 1992
    Co-Authors: Kurt G Naber, U Thyrofffriesinger
    Abstract:

    In a multicentric study comparing oral single-dose therapy of Fosfomycin Trometamol (3 g as Fosfomycin) versus co-trimoxazole (1.92 g) or ofloxacin (200 mg) as many as possible of the pathogens were sent to and analysed in a central laboratory. The pathogens were identified and minimal inhibitory concentrations (MIC) of Fosfomycin, trimethoprim alone and in combination with sulfamethoxazole, ofloxacin, ampicillin, amoxicillin combined with clavulanic acid, and cephadroxil were determined. The eradication of pathogens (cfu < 103/ml at one week after single-dose therapy) was analysed according to species and MIC of the antibiotic used. Urine cultures of 349 patients were analysed.Escherichia coli was the predominating species followed by staphylococci andProteus mirabilis. Enterococci were mostly found in mixed culture. Baseline pathogens of monoinfections were eradicated in 87.1%, in 88.9% and in 86.4% of 284 patients treated with Fosfomycin Trometamol, co-trimoxazole and ofloxacin, respectively. The MICs of the five antibacterial agents and the two antibiotic combinations for 253 baseline pathogens showed that of theE. coli strains none was resistant to ofloxacin, three (MIC=128 mg/l) were resistant to Fosfomycin, 3.6% to co-trimoxazole, 6.2% to trimethoprim, 8.8% to ampicillin, and 5.7% to amoxicillin/clavulanic acid. The eradication rates according to the MICs of the corresponding drugs showed equally good eradication rates for Fosfomycin up to an MIC of 64 mg/l. Above this level two out of three strains were also eradicated by Fosfomycin Trometamol. For co-trimoxazole and ofloxacin no intermediately sensitive or resistant strains were found. Within the range of MICs found there were equally good eradication rates for both antibacterial agents. It was concluded that Fosfomycin Trometamol, ofloxacin and trimethoprim plus sulfamethoxazole can be used as first line antibiotics for single-dose therapy of acute uncomplicated UTI in female patients.

Ram Yahalom - One of the best experts on this subject based on the ideXlab platform.

  • single dose Fosfomycin Trometamol versus 5 day cephalexin regimen for treatment of uncomplicated lower urinary tract infections in women
    Antimicrobial Agents and Chemotherapy, 1994
    Co-Authors: Gai Elhanan, H Tabenkin, Ram Yahalom
    Abstract:

    A randomized study was conducted to assess the clinical and microbiological efficacies of a single 3-g dose of Fosfomycin Trometamol for the treatment of uncomplicated lower urinary tract infections in women compared with a 5-day regimen of cephalexin at 0.5 g four times daily. One hundred twelve women, all of whom had documented infections with bacteria sensitive to both antibiotics, were included. Fifty-eight women received Fosfomycin Trometamol, and 54 women received cephalexin. The two groups did not differ in age, severity, or duration of current urinary tract infection, menstrual status, sexual activity, or use of contraceptives. Ninety percent of pathogens in the Fosfomycin Trometamol group and 81% in the cephalexin group were Escherichia coli (the difference is not significant [NS]). A clinical evaluation at the 5-day follow-up showed that 91% of the women in each group were free of symptoms, while five women in each group were considered therapy failures and were treated by another antibiotic course. A microbiological evaluation at the 5-day follow-up showed a 91% eradication rate in the Fosfomycin Trometamol group and an 83% eradication rate in the cephalexin group (NS). At the 1-month follow-up, a clinical evaluation demonstrated prolonged resolution in 86 and 78%, respectively, of the participating women (NS). A microbiological evaluation at 1 month demonstrated prolonged eradication in 47 (81%) women treated with Fosfomycin Trometamol and in 37 (68%) women treated with cephalexin (NS). Three and six women, respectively, had relapsed. No adverse reactions were reported by the Fosfomycin Trometamol-treated women, while three women treated with cephalexin reported mild adverse reactions but completed the study period. Fosfomycin Trometamol in a single 3-g dose is as effective as a 5-day regimen of cephalexin for the treatment of uncomplicated lower urinary tract infection in women.

J.d. Williams - One of the best experts on this subject based on the ideXlab platform.

  • a comparison between single dose Fosfomycin Trometamol monuril and a 5 day course of trimethoprim in the treatment of uncomplicated lower urinary tract infection in women
    International Journal of Antimicrobial Agents, 1998
    Co-Authors: M A Minassian, Debprasad Chattopadhyay, B Bovill, G J Duckworth, D A Lewis, J.d. Williams
    Abstract:

    Abstract This study is a comparison of the microbiological and clinical efficacy of single-dose Fosfomycin Trometamol therapy and a 5 day course of trimethoprim in the treatment of uncomplicated urinary tract infection in female patients. Urine dip-slide samples were obtained from 547 female patients aged 18–65 by 22 General Practitioners (GPs) participating in the study from 21 centres in the UK. All patients were diagnosed as having a urinary tract infection by their GP on the basis of history and clinical examination. Patients were randomised to receive either single dose Fosfomycin Trometamol or a 5 day course of trimethoprim in a 2:1 ratio. Patients who had significant bacteriuria ( > 10 5 c.f.u /ml) at the first visit (300) were included in the microbiological analysis. The two commonest urinary pathogens isolated were Escherichia coli and Staphylococcus saprophyticus. Trimethoprim resistance was more frequent amongst E. coli isolates whereas Fosfomycin Trometamol resistance was more common amongst S. saprophyticus isolates. Microbiological cure was demonstrated in 83.3% of the trimethoprim treated group and 83% of the Fosfomycin Trometamol treated group. Persistence of the infecting bacteria was seen in 17% of each treatment arm.

Zhaohui Tong - One of the best experts on this subject based on the ideXlab platform.

  • in vitro susceptibility of escherichia coli strains isolated from urine samples obtained in mainland china to Fosfomycin Trometamol and other antibiotics a 9 year surveillance study 2004 2012
    BMC Infectious Diseases, 2014
    Co-Authors: Bei Lai, Bo Zheng, Sainan Zhu, Zhaohui Tong
    Abstract:

    As a result of extensive use of fluroquinlones and cephalosporins, urinary tract pathogens producing extended-spectrum beta-lactamase (ESBL) pose a considerable clinical challenge in the treatment of UTIs. In the present study we retrospectively assessed the susceptibility of E. coli strains to Fosfomycin Trometamol and other antibiotics commonly used for the treatment of such infections. A total of 908 nonreplicate clinical E. coli urinary isolates were collected from 20 Chinese hospitals over four consecutive 1-year periods between October 2004 and June 2012. Susceptibility to antimicrobial agents Fosfomycin Trometamol, piperacillin-tazobactam, cefuroxime, cefotaxime, cefepime, imipenem, amikacin, levofloxacin, and nitrofurantoin was determined using the agar dilution method. A reference strain E. coli (ATCC 25922) was used as a positive control. Results were analyzed using Chi-square test or Fisher’s exact tests. Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem were consistently the most active agents against most of the isolates. There was a decline in susceptibility to cefuroxime, cefotaxime, and cefepime between 2004 and 2010. We showed that 528 of the 908 E. coli isolates (58.1%) produced ESBLs. The ESBL-positive rates increased from 41.7% in 2004−2005 to 60.9% in 2011−2012. ESBL-producing E. coli isolates showed significantly higher resistance rates to levofloxacin than the ESBL-negative isolates. Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem had good activity against both levofloxacin-susceptible and levofloxacin- nonsusceptible isolates (sensitivity rate > 90%). However susceptibility of levofloxacin-resistant isolates to cefuroxime, cefotaxime, cefepime, amikacin, and nitrofurantoin was significantly lower than that of levofloxacin-susceptible isolates. Owing to the increase in the bacterial resistance across the world, the European Urology Association has recommended Fosfomycin Trometamol as the drug of choice in its Guidelines on Urological Infections released in 2013. Our results confirm this recommendation for use in China and continued monitoring of the susceptibility of E. coli to Fosfomycin Trometamol is need with the widely use of the drug in China.

  • in vitro susceptibility of escherichia coli strains isolated from urine samples obtained in mainland china to Fosfomycin Trometamol and other antibiotics a 9 year surveillance study 2004 2012
    BMC Infectious Diseases, 2014
    Co-Authors: Bo Zheng, Yun Li, Zhaohui Tong
    Abstract:

    Background As a result of extensive use of fluroquinlones and cephalosporins, urinary tract pathogens producing extended-spectrum beta-lactamase (ESBL) pose a considerable clinical challenge in the treatment of UTIs. In the present study we retrospectively assessed the susceptibility of E. coli strains to Fosfomycin Trometamol and other antibiotics commonly used for the treatment of such infections.

Bo Zheng - One of the best experts on this subject based on the ideXlab platform.

  • efficacy and safety of oral Fosfomycin Trometamol for the treatment of lower urinary tract infections caused by multi drug resistant bacteria an open label uncontrolled multicenter study
    Chinese Journal of Urology, 2015
    Co-Authors: Ludong Qiao, Bo Zheng, Shan Chen, Yong Yang, Kai Zhang, Hongfeng Guo, Bo Yang, Yuanjie Niu, Yi Wang, Benkang Shi
    Abstract:

    Objective To assess the efficacy and safety of oral Fosfomycin trometamal in patients with lower urinary tract infections (UTIs) caused by multi drug resistant (MDR) bacteria in the clinical setting in China. Methods Multicenter study was conducted from January 2011 to December 2011 in 12 hospitals in China. Three hundred and fifty-six patients with non-fever lower UTls were treated by Fosfomycin trometamal 3 g once daily. Three hundred and fifty cases with complete data were further evaluated. One hundred and twenty(34.3%) were male and 230(65.7%) were female. The average age was (49.9±16.6) years. Depending of the results of urine culture at the first visit, 142 patients with E. coli, Klebsiella pneumonia, proteus, Staphylococcus aureus, Staphylococcus epidermidis and entercocous were analyzed. The susceptibility of MDR bacteria to Fosfomycin Trometamol were calculated. The clinical efficacy, bacteriological efficacy of Fosfomycin Trometamol to these patients was evaluated. Results For the gram-negative bacteria detected by culture, among the E. coli, Klebsiella pneumonia and proteus, 50% (52/104) were Extended-Spectrum β-lactamases producing organisms. For the gram-positive bacteria (n=38) detected by culture, methicillin-resistant staphylococcus accounts for 55% (11/20) of all the Staphylococcus and the other gram-positive bacteria were Enterococcus (n=18). Higher susceptibility rates to Fosfomycin Trometamol were observed among MDR bacteria(85.7%) and the clinical effective rate and bacteriological effective rate of Fosfomycin Trometamol were 96.4%(53/55) and 87.5%(42/48), respectively.The incidence of drug-related adverse events (AEs) was 5.6% (20/356). The most common AE was diarrhea. No drug-related serious adverse events were found. Conclusions The distributions of uropathogens in China are complicated. The detection rate of MDR uropathogens is high. The dosing regimen of Fosfomycin trometamal 3 g once daily is effective and tolerable for the patients with lower UTIs caused by MDR bacteria. It may represent good options for the empiric therapy for the patients with lower UTIs. Key words: Urinary tract infection; Multi drug resistant bacteria; Clinical efficacy; Bacterial sensitivity; Fosfomycin tromethamal

  • in vitro susceptibility of escherichia coli strains isolated from urine samples obtained in mainland china to Fosfomycin Trometamol and other antibiotics a 9 year surveillance study 2004 2012
    BMC Infectious Diseases, 2014
    Co-Authors: Bei Lai, Bo Zheng, Sainan Zhu, Zhaohui Tong
    Abstract:

    As a result of extensive use of fluroquinlones and cephalosporins, urinary tract pathogens producing extended-spectrum beta-lactamase (ESBL) pose a considerable clinical challenge in the treatment of UTIs. In the present study we retrospectively assessed the susceptibility of E. coli strains to Fosfomycin Trometamol and other antibiotics commonly used for the treatment of such infections. A total of 908 nonreplicate clinical E. coli urinary isolates were collected from 20 Chinese hospitals over four consecutive 1-year periods between October 2004 and June 2012. Susceptibility to antimicrobial agents Fosfomycin Trometamol, piperacillin-tazobactam, cefuroxime, cefotaxime, cefepime, imipenem, amikacin, levofloxacin, and nitrofurantoin was determined using the agar dilution method. A reference strain E. coli (ATCC 25922) was used as a positive control. Results were analyzed using Chi-square test or Fisher’s exact tests. Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem were consistently the most active agents against most of the isolates. There was a decline in susceptibility to cefuroxime, cefotaxime, and cefepime between 2004 and 2010. We showed that 528 of the 908 E. coli isolates (58.1%) produced ESBLs. The ESBL-positive rates increased from 41.7% in 2004−2005 to 60.9% in 2011−2012. ESBL-producing E. coli isolates showed significantly higher resistance rates to levofloxacin than the ESBL-negative isolates. Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem had good activity against both levofloxacin-susceptible and levofloxacin- nonsusceptible isolates (sensitivity rate > 90%). However susceptibility of levofloxacin-resistant isolates to cefuroxime, cefotaxime, cefepime, amikacin, and nitrofurantoin was significantly lower than that of levofloxacin-susceptible isolates. Owing to the increase in the bacterial resistance across the world, the European Urology Association has recommended Fosfomycin Trometamol as the drug of choice in its Guidelines on Urological Infections released in 2013. Our results confirm this recommendation for use in China and continued monitoring of the susceptibility of E. coli to Fosfomycin Trometamol is need with the widely use of the drug in China.

  • in vitro susceptibility of escherichia coli strains isolated from urine samples obtained in mainland china to Fosfomycin Trometamol and other antibiotics a 9 year surveillance study 2004 2012
    BMC Infectious Diseases, 2014
    Co-Authors: Bo Zheng, Yun Li, Zhaohui Tong
    Abstract:

    Background As a result of extensive use of fluroquinlones and cephalosporins, urinary tract pathogens producing extended-spectrum beta-lactamase (ESBL) pose a considerable clinical challenge in the treatment of UTIs. In the present study we retrospectively assessed the susceptibility of E. coli strains to Fosfomycin Trometamol and other antibiotics commonly used for the treatment of such infections.

  • In vitro susceptibility of Escherichia coli strains isolated from urine samples obtained in mainland China to Fosfomycin Trometamol and other antibiotics: a 9-year surveillance study (2004-2012)
    bmc infectious diseases, 2014
    Co-Authors: Lai Bei, Bo Zheng, Li Yun, Zhu Sainan, Tong Zhaohui
    Abstract:

    Background: As a result of extensive use of fluroquinlones and cephalosporins, urinary tract pathogens producing extended-spectrum beta-lactamase (ESBL) pose a considerable clinical challenge in the treatment of UTIs. In the present study we retrospectively assessed the susceptibility of E. coli strains to Fosfomycin Trometamol and other antibiotics commonly used for the treatment of such infections. Methods: A total of 908 nonreplicate clinical E. coli urinary isolates were collected from 20 Chinese hospitals over four consecutive 1-year periods between October 2004 and June 2012. Susceptibility to antimicrobial agents Fosfomycin Trometamol, piperacillin-tazobactam, cefuroxime, cefotaxime, cefepime, imipenem, amikacin, levofloxacin, and nitrofurantoin was determined using the agar dilution method. A reference strain E. coli (ATCC 25922) was used as a positive control. Results were analyzed using Chi-square test or Fisher's exact tests. Results: Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem were consistently the most active agents against most of the isolates. There was a decline in susceptibility to cefuroxime, cefotaxime, and cefepime between 2004 and 2010. We showed that 528 of the 908 E. coli isolates (58.1%) produced ESBLs. The ESBL-positive rates increased from 41.7% in 2004-2005 to 60.9% in 2011-2012. ESBL-producing E. coli isolates showed significantly higher resistance rates to levofloxacin than the ESBL-negative isolates. Fosfomycin Trometamol, piperacillin-tazobactam, amikacin, and imipenem had good activity against both levofloxacin-susceptible and levofloxacin-nonsusceptible isolates (sensitivity rate > 90%). However susceptibility of levofloxacin-resistant isolates to cefuroxime, cefotaxime, cefepime, amikacin, and nitrofurantoin was significantly lower than that of levofloxacin-susceptible isolates. Conclusions: Owing to the increase in the bacterial resistance across the world, the European Urology Association has recommended Fosfomycin Trometamol as the drug of choice in its Guidelines on Urological Infections released in 2013. Our results confirm this recommendation for use in China and continued monitoring of the susceptibility of E. coli to Fosfomycin Trometamol is need with the widely use of the drug in China.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000331207500005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Infectious DiseasesSCI(E)5ARTICLEtongzhh@hotmail.comnull1