目的:加拿大静脉注射磷霉素的使用数据有限。我们使用CLEAR注册表捕获的数据报告了在加拿大患者中使用IV磷霉素。
方法:CLEAR注册表使用基于Web的数据管理程序,REDCapTM(在线调查https://rcsurvey。Radyfhs.umanitoba.ca/调查/?s=F7JXNDFXEF),以帮助临床医生输入与使用IV磷霉素的临床经验相关的详细信息。
结果:可获得59例静脉磷霉素治疗患者的数据。最常见的感染是:菌血症或败血症(25.4%的患者),复杂UTI(20.3%),呼吸机相关细菌性肺炎(18.6%),和医院获得性肺炎(13.6%)。IV磷霉素用于治疗革兰氏阴性(88.1%)或革兰氏阳性(10.2%)感染。最常见的病原菌为耐碳青霉烯类肠杆菌(CRE)(44.1%),MDR铜绿假单胞菌(18.6%),耐万古霉素屎肠球菌(VRE)(5.1%),和MRSA(3.4%)。IV磷霉素的主要使用是由于对初始处方疗法的抗性(69.5%),并且经常与其他药物联合使用(86.4%)。微生物成功(根除/推定根除)发生在77.4%,临床成功(临床治愈/改善)发生在62.5%的患者;15.3%的患者因感染而死亡。73.1%的患者没有记录到不良反应,也没有患者因不良反应而停止治疗。
结论:在加拿大,IV磷霉素主要用作定向疗法以治疗由革兰氏阴性和革兰氏阳性细菌引起的各种严重感染。它主要用于感染对其他药物具有抗性的细菌的患者,并作为联合治疗的一部分。它的使用与相对较高的微生物和临床治愈率有关,和出色的安全性。
Data on the use of intravenous (IV) fosfomycin in Canada are limited. Using data captured by the Canadian LEadership on Antimicrobial Real-life usage (
CLEAR) registry, we report the use of IV fosfomycin in Canadian patients.
The
CLEAR registry uses the web-based data management program, REDCapTM (https://rcsurvey.radyfhs.umanitoba.ca/surveys/?s=F7JXNDFXEF) to facilitate clinicians\' entering of details associated with their clinical experiences using IV fosfomycin.
Data were available for 59 patients treated with IV fosfomycin. The most common infections treated were: bacteraemia or sepsis (25.4% of patients), complicated urinary tract infection (20.3%), ventilator-associated bacterial pneumonia (18.6%), and hospital-acquired pneumonia (13.6%). IV fosfomycin was used to treat Gram-negative (88.1%) and Gram-positive (10.2%) infections. The most common pathogens treated were carbapenem-resistant Enterobacterales (44.1%), multidrug-resistant Pseudomonas aeruginosa (18.6%), vancomycin-resistant Enterococcus faecium (5.1%), and methicillin-resistant Staphylococcus aureus (3.4%). IV fosfomycin was primarily used due to resistance to initially prescribed therapies (69.5%), frequently in combination with other agents (86.4%). Microbiological success (eradication/presumed eradication) occurred in 77.4% of patients, and clinical success (clinical cure/improvement) occurred in 62.5%. Overall, 15.3% of patients died because of their infection. Adverse effects were not documented in 73.1% of patients, and no patient discontinued therapy because of an adverse effect.
In Canada, IV fosfomycin is used primarily as directed therapy to treat a variety of severe infections caused by Gram-negative and Gram-positive bacteria. It is primarily used in patients infected with bacteria resistant to other agents and as part of combination therapy. Its use is associated with relatively high microbiological and clinical cure rates, and it has an excellent safety profile.