Objectives: The goal to prevent increasing antibiotic resistance in urologic procedures has a significant impact on the choice of preoperative antibiotic prophylaxis. The efficacy of an old-new antibioticfosfomycin in TRUS-guided prostate biopsy was also evaluated. Methods: Included were patients who underwent TRUS-guided prostate biopsy from August 1, 2015- July 31, 2016. Patients who satisfied the inclusion criteria were included. Patients were asked to take a single dose of 3g oral fosfomycin 1-3 hours prior to the procedure. Urinalysis was taken pre biopsy and post biopsy (at least 7-10 days). Occurrence of afebrile and febrile UTI were noted. Patients were informed of the signs and symptoms that need to be reported to the investigators. Results: There were 74 patients enrolled in the study. The mean average age of patients was 66.5(±7). Majority of patients were having moderate lower urinary tract symptoms (40.5%) followed by patients with indwelling foley catheter (31.1%). Seventeen percent of patients had concomitant diseases like diabetes mellitus, cystolithiasis, nephrolithiasis, hypertension, etc. Pre biopsy, 51.4% of patients had asymptomatic urinary tract infection and 35% of these patients showed resolution of UTI post biopsy. The incidence of febrile UTI was 4%, 3.8% of patients with UTI pre biopsy and 50% of patients without UTI pre biopsy. Finally, the presence of afebrile and febrile UTI pre and post biopsy was statistically significant at 5% level of significance. Conclusion Single dose oral fosfomycin as prophylactic antibiotic in TRUS- guided prostate biopsy can be an alternative to reduce the rate of fluoroquinolone- resistant infections.
Fosfomycin ; Urinary Tract Infections

The therapeutic efficacy and significance of intraprostatic fosfomycin injection in treating patients with chronic prostatitis were reviewed. During the last 6 years, 350 patients were treated with intraprostatic fosfomycin injection for chronic prostatitis, and among them, 218 patients who could be followed up at least for 3 months were analysed. As for chronic prostatitis, when a patient's WBC count of EPS per high power field remains invariable below 15 for at least 3 months, he is said to be cured. Intraprostatic injection was performed once or twice in all patients and 153 (70.2%) cases were responsive to this treatment. But eleven patients recurred immediately within 3 months after the response. Therefore, final cure rate reached 65.1% (142/218): Adverse effects were rare, if any, they were just trivial symptoms such as mild suprapubic pain or discomfort, transient hematuria and hemospermia. These facts demonstrate that intraprostatic fosfomycin injection has much advantage in patients with chronic prostatitis as treatment modality compared with ordinary method.
Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostatitis*

The results of intraprostatic injection of fosfomycin were compared to those of oral minocycline therapy in patients with nonbacterial prostatitis. Nonbacterial prostatitis did not recur in 26 out of 33 patients with fosfomycin injected into the prostate and in 16 out of 48 patients treated with oral minocycline. Non-recurrence rate within each group was compared as 78.8 per cent to 33.3 per cent, respectively, demonstrating that intraprostatic fosfomycin treatment was more successful than oral minocycline therapy. The pain and discomfort experienced by the patients during direct injection into the prostate was minimal. Hematuria was always practically present after the injection. Intraprostatic fosfomycin injection is believed to be new alternative method in the treatment of nonbacterial prostatitis.
Fosfomycin* ; Hematuria ; Humans ; Minocycline* ; Prostate ; Prostatitis*

Carbapenem-resistant Enterobacteriaceae (CRE) are now spread worldwide. In Korea, the number of CRE isolation is rapidly increasing, and impending endemicity is a concern. To cope well with CRE, thorough infection control, such as active surveillance, early detection, strict contact precaution, cleaning the environment, and antibiotic stewardship is very important. Therapeutic options include polymyxin, tigecycline, fosfomycin or the combination of them with carbapenem, which is currently the mainstay of treatment. In addition, various combination regimens with new carbapenemase inhibitors such as avibactam, vaborbactam, or relebactam, and other classes of antimicrobials such as plazomicin and siderophore cephalosporin are in the process of evaluation.
Carbapenems ; Enterobacteriaceae* ; Fosfomycin ; Infection Control ; Korea ; Polymyxins

Seventeen patients were treated for chronic bacterial prostitis by an injection of 2 gm fosfomycin sodium via perineal route directly into the prostate. Cure rate was 70% of the seven patients who allowed follow-up study at six months after Treatment with one injection. The pain, discomfortness, hematuria and hemospermia were improved except one case. Results demonstrated that direct injection into the prostate offers a new alternative method in the treatment of chronic bacterial prostatitis.
Follow-Up Studies ; Fosfomycin* ; Hematuria ; Hemospermia ; Humans ; Prostate* ; Prostatitis* ; Sodium*

BACKGROUND AND OBJECTIVES: The use of cisplatin as a therapeutic drug in malignant neoplasm is known to have associated side effects such as nephrotoxicity and ototoxicity. Although the nephrotoxic effect of this drug can be somewhat decreased by use of the hydration method, prevention of the ototoxic effect, which is known to induce irreversible change on the cochlea, has not been well established. The purose of this study is to evaluate the preventive effect of fosfomycin in cisplatin induced ototoxicity. METHODS: Fosfomycin was used to reduce the ototoxic effects of cisplatin, and its efficacies were evaluated anatomically as well as physiologically. Anatomically, a histologic study of cochleas was carried out by scanning electro-microscopy, and physiologically, cochlear microphonics and compound action potentials were studied in guinea pigs. RESULTS: Protection against distortion and loss of outer hair cells in the basal turn of cochlea caused by cisplatin was found to be statistically significant in the groups injected with fosfomycin. CONCLUSION: Fosfomycin was found to be effective in providing protection against cisplatin induced ototoxicity.
Action Potentials ; Animals ; Cisplatin* ; Cochlea* ; Fosfomycin* ; Guinea Pigs* ; Guinea* ; Hair

OBJECTIVE: To investigate the molecular mechanism underlying inherent fosfomycin resistance of Klebsiella pneumoniae (K. pneumoniae). METHODS: The draft genomic sequences of 14 clinical hypervirulent/hypermucoviscous K. pneumoniae (HvKP/ HmKP) isolates were obtained using the next-generation sequencing technology. The genomic sequences were analyzed using the Resistance Gene Identifier (RGI) software for predicting the resistome based on homology and SNP models in the Comprehensive Antibiotic Resistance Database (CARD) and for identification of the presence of phosphomycin resistancerelated genes uhpt and fosA and their mutations in the bacterial genomes. The results were verified by analyzing a total of 521 full-length genomic sequences of K. pneumonia strains obtained from GenBank. RESULTS: All the 14 clinical isolates of HvKP/ HmKP carried hexose phosphate transporter (UhpT) gene mutation, in which the glutamic acid was mutated to glutamine at 350aa (UhpT^E350Q mutation); the presence of fosA6 gene was detected in 12 (85.71%) of the isolates and fosA5 gene was detected in the other 2 (14.29%) isolates. Analysis of the genomic sequences of 521 K. pneumonia strains from GenBank showed that 508 (97.50%) strains carried UhpT^E350Q mutation, 439 (84.26%) strains harbored fosA6, and 80 (15.36%) strains harbored fosA5; 507 (97.31%) strains were found to have both UhpT^E350Q mutation and fosA6/5 genes in the genome. Only 12 (2.30%) strains carried fosA6/5 genes without UhpT^E350Q mutation; 1 (0.19%) strain had only UhpT^E350Q mutation without fosA6/5 genes, and another strain contained neither UhpT^E350Q mutation nor fosA6/5 genes. CONCLUSION UhpT^E350Q mutation with the presence of fosA6/5 genes are ubiquitous in K. pneumonia genomes, indicating a possible intrinsic mechanism of fosfomycin resistance in the bacterium to limit the use of fosfomycin against infections caused by K. pneumoniae, especially the multi-resistant HvKP/HmKP strains.
Fosfomycin ; Klebsiella pneumoniae ; Mutation ; Databases, Factual ; High-Throughput Nucleotide Sequencing

Rapidly increasing antimicrobial resistance and lack of effective antibiotics are dilemma in the treatment of infectious diseases. Clinicians are now considering the use of old antibiotics such as colistin, fosfomycin because of limitation of therapeutic options. The unique pharmacokinetic and pharmacodynamics properties of these antibiotics have led the new therapeutic approaches, such as the combination of agents and newer dosing regimens. Colistin has become the last drug of the treatment of multidrug resistant gram-negative bacteria and the loading dose and high dose maintenance has been suggested. Tigecycline is licensed for the treatment of complicated skin and intra-abdominal infections and has broad activity against gram-positive and gram-negative pathogens but cautious use in the treatment of bloodstream infection and pneumonia is recommended. Oral and intravenous fosfomycin may be effective treatment options in the case of resistant gram-negative infections but clinical studies are limited.
Anti-Bacterial Agents ; Bacteria* ; Colistin ; Communicable Diseases ; Fosfomycin ; Gram-Negative Bacteria ; Intraabdominal Infections ; Pneumonia ; Skin

BACKGROUND: Vancomycin-resistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. Alternatives to vancomycin are few because VRE are frequently resistant to commonly used antimicrobial agents. The present study was designed to assess the in-vitro activity of fosfomycin to clinical isolates of VRE. METHODS: For 199 VRE isolates from 1995 to 2000, and 91 enterococcal isolates that were consecutively isolated during the January of 2001 at Wonju Christian Hospital, fosfomycin (200 microgram) disk diffusion test was done by NCCLS method. The number of enterococcal isolates tested for fosfomycin were as follows:58 E. faecalis (42 vancomycin susceptible isolates, 16 vancomycin resistant isolates, and 1 vancomycin intermediate resistance isolate); 210 E. faecium (185 vancomycin resistant and 25 vancomycin susceptible isolates); 15 E. gallinarum, and 6 E. casseliflavus isolates. RESULTS: Among the VRE isolates, the resistance rates of fosfomycin according to enterococcal species were 6.3% in E. faecalis, 4.9% in E. faecium, 0% in E. casseliflavus, and 16.7% in E. gallinarum. CONCLUSION: Fosfomycin could be a potentially useful drug for the treatment of infections caused by VRE.
Anti-Infective Agents ; Diffusion ; Enterococcus faecalis ; Enterococcus faecium ; Fosfomycin* ; Gangwon-do ; Incidence ; Korea ; Vancomycin*

Twenty-four patients with lower urinary tract infection have been treated with 7-day course of oral fosfomycin and following results were obtained. 1. Clinical result of 11 cases of acute uncomplicated infection was excellent in 10 and good in 1, efficacy rate being 100%. 2. Clinical result of 7 cases of complicated infection was excellent in 4, good in 1 and poor in 2, efficacy rate being 71%. 3. Clinical result of 4 cases of asymptomatic bacteriuria was excellent in 1 and poor in 3, efficacy rate being 25%. 4. Both 1 case of NGU and 1 case of acute epididymitis probably caused by Chlamydial or Mycoplasmal infection were not improved. 5. No significant side effect except mild headache and dizziness was observed. In conclusion, oral fosfomycin is a safe and very useful drug especially in the treatment of acute uncomplicated lower urinary tract infection.
Bacteriuria ; Dizziness ; Epididymitis ; Fosfomycin ; Headache ; Humans ; Male ; Urinary Tract Infections* ; Urinary Tract*