title: Fosfomycin synergy in vitro with amoxicillin, daptomycin, and linezolid against vancomycin-resistant Enterococcus faecium from renal transplant patients with infected urinary stents.
abstract: Fosfomycin is a potential option for vancomycin-resistant enterococcus (VRE) infections despite limited in vitro and clinical data. In this study, 32 VRE isolates from renal transplant patients with urinary stent infections were susceptible to fosfomycin, daptomycin, and linezolid and resistant to amoxicillin, minocycline, and nitrofurantoin based on their MIC(50)s and MIC(90)s. Fosfomycin was bacteriostatic at 0.5 to 16× the MIC (32 to 2,048 μg/ml); synergy occurred when fosfomycin was combined with daptomycin (2.8 to 3.9 log(10) CFU/ml kill; P < 0.001) or amoxicillin (2.6 to 3.4; P < 0.05). These combinations may be potent options to treat VRE urinary infections pending investigation of clinical efficacy.
authors.affiliation: Pharmacy Practice Division, University of Wisconsin School of Pharmacy, Madison, WI, USA.
authors.forename: Jillian L
authors.initials: JL
authors.lastname: Descourouez
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Jorgenson
authors.forename: Justine E
authors.initials: JE
authors.lastname: Wergin
authors.forename: Warren E
authors.initials: WE
authors.lastname: Rose
mesh_terms: D000081:Acetamides / Q000494:pharmacology*; D000658:Amoxicillin / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017576:Daptomycin / Q000494:pharmacology*; D004357:Drug Synergism; D016984:Enterococcus faecium / Q000187:drug effects* / Q000254:growth & development / Q000302:isolation & purification; D005578:Fosfomycin / Q000494:pharmacology*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D016030:Kidney Transplantation; D000069349:Linezolid; D008826:Microbial Sensitivity Tests; D023303:Oxazolidinones / Q000494:pharmacology*; D015607:Stents / Q000382:microbiology; D014551:Urinary Tract / Q000187:drug effects / Q000382:microbiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D014640:Vancomycin / Q000494:pharmacology; D020713:Vancomycin Resistance
chemical_list: D000081:Acetamides; D000900:Anti-Bacterial Agents; D023303:Oxazolidinones; D005578:Fosfomycin; D014640:Vancomycin; D000658:Amoxicillin; D000069349:Linezolid; D017576:Daptomycin