Yikes.

Never have I treated something that probably doesn't need to be treated so aggressively. Or at least expensively.

Yeah, IDSA is struggling #idsky

Update: The original link appears to be temporarily unavailable. I'll share the updated official link once it's available. #idsky

Even worse, cefidrocol first line now based on rabbit data #idsky

The dose of fosfomycin matters, it seems like 3g q24h is more consistent with clinical success, but tolerability esp diarrhea might be an issue here

If there were PK/PD issues with fosfo, the problem might arise not on early TOC, but on relapses of non-cystitis UTI.

In this subanalysis of patients switched to oral in FOREST trial, more relapses were observed with fosfo for bacteremic E. coli UTI.

academic.oup.com/jac/article/... #IDSky #UTIsky

Caveats:
- FOREST was 100% bacteremic UTI
- A lower dose of oral fosfo was used (3g/48h).
- Definition of relapse was more strict, requiring a new isolation of E. coli with same phenotype.
- Absolute risk difference still low (11%), so definitely an option to consider if no other options!

#IDSky

star wars

Observational indeed

Sort of

Two words