Fosfomycin Tromeltamol (FOS) Is an Effective Alternative in Post Renal Transplant Urinary Tract Infection Prophylaxis Caused by Escherichia coli and Enterococcus faecalis without Increasing Resistance Rate.
1Nephrology and Transplantation, Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
2Transplantation, Instituto Nacional de Nutrición Salvador Zubirán, Mexico, Mexico
3Medicine, Instituto Nacional de Nutrición Salvador Zubirán, Mexico, Mexico
Meeting: 2017 American Transplant Congress
Abstract number: 340
Keywords: Bacterial infection, Kidney transplantation
Session Information
Session Name: Concurrent Session: Infectious Pot-Pourri
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: E265
Urinary tract infection (UTI) is one of the most important complications in renal transplant recipients (rTR) during the first year after renal transplantation (RT). Antimicrobial prophylaxis is controversial due to concerns about induction of bacterial resistance. The aim of the present study was to compare the efficacy of FOS with trimethoprim/sulfamethoxazole (TMP/SMX) in the prophylaxis of UTI during the first 6 months after RT, in the three most common isolated bacteria in our institution: E. coli, Klebsiella spp. and E. faecalis. Methods: This is a post-hoc analysis of a randomized control trial in rTR, conducted in our institution between May 2013 and June 2014. The intervention group received FOS 3 geach 10 days and the control group TMP/SMX 160/800 mg per day. UTI was defined as bacteriuria > 1x 105 CFU with or without symptoms. The incidence of UTI and resistance rate was compared between groups and by bacterial species. Results: Sixty seven patients were included (FOS=32 and TMP/SMX=35). There were 16 episodes of UTI caused by E. coli (FOS 12.5 % and TMP/SMT 34.2 %, p=0.047), 15 by Klebsiella spp (25 and 20 %, respectively, p=0.62) and 4 by E. faecalis (0 and 11.4 %, respectively). Including low grade bacteriuria (1 x103 and 1 x 104), there was no differences in the rate of E. Coli Fosfomycin resistance rate. Meanwhile in the E. Faecalis isolations in the FOS group (1 x 103) all were resistant. In both groups and in all bacteriuria quantities, Klebsiella spp, was resistant to FOS. 
Conclusions: FOS is more effective than TMP-SMX in the prophylaxis of UTI caused by E. Coli and E. Faecalis, without increasing the resistance rate.
CITATION INFORMATION: Arreola-Guerra J, Alberu J, Morales-Buenrostro L, Maravilla E, Rosado R, Sifuentes J. Fosfomycin Tromeltamol (FOS) Is an Effective Alternative in Post Renal Transplant Urinary Tract Infection Prophylaxis Caused by Escherichia coli and Enterococcus faecalis without Increasing Resistance Rate. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Arreola-Guerra J, Alberu J, Morales-Buenrostro L, Maravilla E, Rosado R, Sifuentes J. Fosfomycin Tromeltamol (FOS) Is an Effective Alternative in Post Renal Transplant Urinary Tract Infection Prophylaxis Caused by Escherichia coli and Enterococcus faecalis without Increasing Resistance Rate. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/fosfomycin-tromeltamol-fos-is-an-effective-alternative-in-post-renal-transplant-urinary-tract-infection-prophylaxis-caused-by-escherichia-coli-and-enterococcus-faecalis-without-increasing-resistance/. Accessed May 13, 2025.« Back to 2017 American Transplant Congress