{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:31:00Z","timestamp":1777923060594,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2021,5]]},"abstract":"\n Background:<\/jats:title>\n \n In India, multidrug resistance in community and hospital associated Gram-negative pathogens has increased sharply over the past few years. In the absence of novel oral multidrug resistant-pathogen active therapies, the therapeutic situation with regard to community infections is even more challenging. Hence, the focus is now shifting toward potentially expanding the utility of older antibiotics such as fosfomycin and nitrofurantoin beyond their approved pathogen coverage. The current study was undertaken to assess the activity of fosfomycin and nitrofurantoin against\n Enterobacterales<\/jats:italic>\n pathogens through minimum inhibitory concentration (MIC) determination to facilitate monitoring future shifts in susceptibility to these agents.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n The present study used 1,350\n Enterobacterales<\/jats:italic>\n , recently collected from various Indian tertiary care hospitals and preserved at Wockhardt Strain Repository. The MIC\n 50\/90<\/jats:sub>\n for fosfomycin and nitrofurantoin and the comparator antibiotics was determined for\n Escherichia coli<\/jats:italic>\n (\n N<\/jats:italic>\n \u2009=\u2009470),\n Klebsiella pneumoniae<\/jats:italic>\n (\n N<\/jats:italic>\n \u2009=\u2009429),\n Enterobacter<\/jats:italic>\n spp., (\n N<\/jats:italic>\n \u2009=\u2009144),\n Proteus<\/jats:italic>\n spp. (\n N<\/jats:italic>\n \u2009=\u2009262), and\n Citrobacter<\/jats:italic>\n spp. (\n N<\/jats:italic>\n \u2009=\u200945), using Clinical and Laboratory Standards Institute recommended agar dilution method.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Applying\n E. coli<\/jats:italic>\n breakpoints, the susceptibility rates of fosfomycin for\n E. coli<\/jats:italic>\n ,\n K. pneumoniae<\/jats:italic>\n ,\n Enterobacter<\/jats:italic>\n spp.,\n Proteus<\/jats:italic>\n spp., and\n Citrobacter<\/jats:italic>\n spp., were 95.5%, 53.2%, 71.5%, 76.7%, and 91.1%, respectively. Applying respective breakpoints, the susceptibility rates of comparator drugs, including meropenem, were lower than fosfomycin. Susceptibility of nitrofurantoin for\n E. coli<\/jats:italic>\n and\n Citrobacter<\/jats:italic>\n isolate was 83%, while limited coverage (<13.2% susceptibility) was observed for other genera.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Amidst widespread resistance,\n a<\/jats:italic>\n \u2009>\u200970% fosfomycin susceptibility observed for clinical isolates, including strains expressing carbapenemases, is encouraging and supports conducting additional susceptibility and pharmacokinetic\/pharmacodynamic studies to explore its potential for expanded therapeutic use. Nitrofurantoin activity spectrum was restricted to\n E. coli<\/jats:italic>\n and\n Citrobacter<\/jats:italic>\n spp. and, therefore, offers a relatively limited therapeutic scope.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/mdr.2020.0200","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T12:38:50Z","timestamp":1602679130000},"page":"678-684","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["In Vitro<\/i>\n Activity of Fosfomycin and Nitrofurantoin Against Contemporary\n Enterobacterales<\/i>\n Pathogens Isolated from Indian Tertiary Care Hospitals"],"prefix":"10.1177","volume":"27","author":[{"given":"Rajesh","family":"Chavan","sequence":"first","affiliation":[{"name":"Badrinarayan Barwale Mahavidyalaya, Jalna, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhushan","family":"Naphade","sequence":"additional","affiliation":[{"name":"Badrinarayan Barwale Mahavidyalaya, Jalna, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhalchandra","family":"Waykar","sequence":"additional","affiliation":[{"name":"Department of Zoology, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Bhagwat","sequence":"additional","affiliation":[{"name":"Wockhardt Research Centre, D4 MIDC, Aurangabad, India."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Indian Council of Medical Research (ICMR).. 2017. Annual report Antimicrobial Resistance Surveillance Network January 2017\u2013December 2017. ICMR India. Available at https:\/\/main.icmr.nic.in\/sites\/default\/files\/reports\/annual_report_amr_jan2017-18.pdf (accessed July25 2019)."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.2174\/1874285801206010074"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/2279-042X.162360"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01222-13"},{"key":"e_1_3_5_6_2","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3390\/medicina55060285","article-title":"Resistance trends and epidemiology of citrobacter-enterobacter-serratia in urinary tract infections of inpatients and outpatients (RECESUTI): A 10-year survey","volume":"55","author":"Gajd\u00e1cs M.","year":"2019","unstructured":"Gajd\u00e1cs M., , and Urb\u00e1n E.. 2019. Resistance trends and epidemiology of citrobacter-enterobacter-serratia in urinary tract infections of inpatients and outpatients (RECESUTI): A 10-year survey. Medicina, 55:285.","journal-title":"Medicina"},{"key":"e_1_3_5_7_2","unstructured":"Forest Pharmaceuticals Inc. 2008. Highlights of prescribing Information: MONUROL (fosfomycin tromethamine) single-dose sachet containing granules for oral use. Available at https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2008\/050717s005lbl.pdf (accessed August2 2019)."},{"key":"e_1_3_5_8_2","first-page":"845","article-title":"Fosfomycin for the treatment of resistant gram-negative bacterial infections","volume":"34","author":"Reffert J.L.","year":"2014","unstructured":"Reffert J.L., , and Smith W.J.. 2014. Fosfomycin for the treatment of resistant gram-negative bacterial infections. Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy, 34:845\u2013857.","journal-title":"Insights from the Society of Infectious Diseases Pharmacists. Pharmacotherapy"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2016.04.014"},{"key":"e_1_3_5_10_2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.18773\/austprescr.2019.002","article-title":"Nitrofurantoin and fosfomycin for resistant urinary tract infections: old drugs for emerging problems","volume":"42","author":"Gardiner B.J.","year":"2019","unstructured":"Gardiner B.J., , Stewardson A.J, , Abbott I.J, , and Peleg A.Y.. 2019. Nitrofurantoin and fosfomycin for resistant urinary tract infections: old drugs for emerging problems. Aust Prescr. 42:14\u201319.","journal-title":"Aust Prescr"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-009-0833-2"},{"key":"e_1_3_5_12_2","unstructured":"Clinical and Laboratory Standards Institute (CLSI). 2018. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. Approved Standard. 11th ed. CLSI Document M07. CLSI Wayne PA."},{"key":"e_1_3_5_13_2","unstructured":"Clinical and Laboratory Standards Institute (CLSI). 2020. Performance Standards for Antimicrobial Susceptibility Testing. Approved Standard. 30th ed. CLSI Document M100. CLSI Wayne PA."},{"key":"e_1_3_5_14_2","doi-asserted-by":"crossref","first-page":"00672","DOI":"10.1128\/AAC.00672-19","article-title":"Activity of imipenem-relebactam and comparator agents against genetically characterized isolates of carbapenem-resistant Enterobacteriaceae","volume":"63","author":"Canver C.","year":"2019","unstructured":"Matthew Canver C., , Satlin M.J, , Westblade L.F, , Kreiswirth B.N, , Chen L., , Robertson A., , Fauntleroy K., , Spina M.L, , Callan K., , and Jenkins S.G.. 2019. Activity of imipenem-relebactam and comparator agents against genetically characterized isolates of carbapenem-resistant Enterobacteriaceae. Antimicrob. Agents. Chemother. 63:00672-19.","journal-title":"Antimicrob. Agents. Chemother"},{"key":"e_1_3_5_15_2","doi-asserted-by":"crossref","first-page":"e00642","DOI":"10.1128\/AAC.00642-17","article-title":"Identifying spectra of activity and therapeutic niches for ceftazidime-avibactam and imipenem-relebactam against carbapenem-resistant Enterobacteriaceae","volume":"61","author":"Haidar G.","year":"2017","unstructured":"Haidar G., , Clancy C.J, , Chen L., , Samanta P., , Shields R.K, , Kreiswirth B.N, , and Hong Nguyen M.. 2017. Identifying spectra of activity and therapeutic niches for ceftazidime-avibactam and imipenem-relebactam against carbapenem-resistant Enterobacteriaceae. Antimicrob Agents Chemother. 61:e00642-17.","journal-title":"Antimicrob Agents Chemother"},{"key":"e_1_3_5_16_2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jiac.2016.01.010","article-title":"Fosfomycin: Resurgence of an old companion","author":"Sastry S.","year":"2016","unstructured":"Sastry S., , and Doi Y.. 2016. Fosfomycin: Resurgence of an old companion. J. infect. Chemother. 22: 273\u2013280.","journal-title":"J. infect. Chemother. 22"},{"key":"e_1_3_5_17_2","first-page":"Abstract","article-title":"Fosfomycin activity when tested against gram-positive and gram-negative US isolates collected by the SENTRY Antimicrobial Surveillance Program","volume":"1","author":"Flamm R.K.","year":"2017","unstructured":"Flamm R.K., , Shortridge D., , Rhomberg P.R, , Sweeney K., , Ellis-Grosse E.J, , and Sader H.S. 2017. Fosfomycin activity when tested against gram-positive and gram-negative US isolates collected by the SENTRY Antimicrobial Surveillance Program. Abstract presented at the ASM Microbe, New Orleans, Louisiana, USA, June, 1\u20135, Abstract No. Saturday-57.","journal-title":"Abstract presented at the ASM Microbe, New Orleans, Louisiana, USA, June"},{"key":"e_1_3_5_18_2","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1128\/AAC.02399-13","article-title":"In vitro activity of fosfomycin against Escherichia coli isolated from patients with urinary tract infections in Canada as part of the CANWARD surveillance study","volume":"58","author":"Karlowsky J.A.","year":"2014","unstructured":"Karlowsky J.A., , Denisuik A.J, , Lagac\u00e9-Wiens P.R, , Adam H.J, , Baxter M.R, , Hoban D.J, , and Zhanel G.G.. 2014. In vitro activity of fosfomycin against Escherichia coli isolated from patients with urinary tract infections in Canada as part of the CANWARD surveillance study. Antimicrob. Agents. Chemother. 58:1252\u20131256.","journal-title":"Antimicrob. Agents. Chemother"},{"key":"e_1_3_5_19_2","first-page":"90","article-title":"Determination of extended-spectrum \u03b2-lactamases and ampcproduction in uropathogenicisolates of Escherichia coli and susceptibility to fosfomycin","volume":"5","author":"Gupta V.","year":"2013","unstructured":"Gupta V., , Rani H., , Singla N., , Kaistha N., , and Chander J.. 2013. Determination of extended-spectrum \u03b2-lactamases and ampcproduction in uropathogenicisolates of Escherichia coli and susceptibility to fosfomycin. J. Lab. Phys. 5:90\u201393.","journal-title":"J. Lab. Phys"},{"key":"e_1_3_5_20_2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.2174\/1871526515666150916141907","article-title":"Fosfomycin use in multi drug resistant uropathogenic Escherichia coli","volume":"15","author":"Mittal S.","year":"2015","unstructured":"Mittal S., , Sharma M., , and Chaudhary U.. 2015. Fosfomycin use in multi drug resistant uropathogenic Escherichia coli. Infect. Disord. Drug. Targets, 15:196\u2013201.","journal-title":"Infect. Disord. Drug. Targets"},{"key":"e_1_3_5_21_2","first-page":"DC06","article-title":"Fosfomycin: An alternative therapy for the treatment of UTI amidst escalating antimicrobial resistance","volume":"9","author":"Sabharwal E.R.","year":"2015","unstructured":"Sabharwal E.R., , and Sharma R.. 2015. Fosfomycin: An alternative therapy for the treatment of UTI amidst escalating antimicrobial resistance. J. Clin. Diagn. Res. 9:DC06-DC09.","journal-title":"J. Clin. Diagn. Res"},{"key":"e_1_3_5_22_2","doi-asserted-by":"crossref","first-page":"675","DOI":"10.2217\/fmb.13.31","article-title":"Evaluation of fosfomycin activity against uropathogens in a fosfomycin-naive population in South India: A prospective study","volume":"8","author":"Sahni R.D.","year":"2013","unstructured":"Sahni R.D., , Balaji V., , Varghese R., , John J., , Tansarli G.S, , and Falagas M.E.. 2013. Evaluation of fosfomycin activity against uropathogens in a fosfomycin-naive population in South India: A prospective study. Future Microbiol. 8:675\u2013680.","journal-title":"Future Microbiol"},{"key":"e_1_3_5_23_2","doi-asserted-by":"crossref","unstructured":"Rajenderan S. Balaji V. Anandan S. Sahni R.D Tansarli G.S and Falagas M.E.. 2014 Determination of MIC distribution of arbekacin cefminox fosfomycin biapenem and other antibiotics against Gram-negative clinical isolates in South India: A prospective study. PLoS One 9:e103253.","DOI":"10.1371\/journal.pone.0103253"},{"key":"e_1_3_5_24_2","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1128\/AAC.50.1.368-370.2006","article-title":"In vitro activity of fosfomycin against extended-spectrum-\u03b2-lactamase producing Escherichia coli and Klebsiella pneumoniae: comparison of susceptibility testing procedures","volume":"50","author":"De Cueto M.","year":"2006","unstructured":"De Cueto M., , Lopez L., , Hernandez J.R, , Morillo C., , and Pascual A.. 2006. In vitro activity of fosfomycin against extended-spectrum-\u03b2-lactamase producing Escherichia coli and Klebsiella pneumoniae: comparison of susceptibility testing procedures. Antimicrob. Agents. Chemother. 50:368\u2013370.","journal-title":"Antimicrob. Agents. Chemother"},{"key":"e_1_3_5_25_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.4103\/iju.IJU_285_16","article-title":"Fosfomycin susceptibility among multidrug-resistant, extended-spectrum beta-lactamase-producing, carbapenem-resistant uropathogens","volume":"33","author":"Banerjee S.","year":"2017","unstructured":"Banerjee S., , Sengupta M., , and Sarker T.K.. 2017. Fosfomycin susceptibility among multidrug-resistant, extended-spectrum beta-lactamase-producing, carbapenem-resistant uropathogens. Indian. J. Urol. 33:149\u2013154.","journal-title":"Indian. J. Urol"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.4103\/0255-0857.167350"},{"key":"e_1_3_5_27_2","first-page":"39","article-title":"Role of old antibiotics in the era of antibiotic resistance","volume":"3","author":"Munoz-Davila, M.J","year":"2014","unstructured":"Munoz-Davila, M.J. 2014. Role of old antibiotics in the era of antibiotic resistance. Highlighted nitrofurantoin for the treatment of lower urinary tract infections. Antibiotics. 3:39\u201348.","journal-title":"Highlighted nitrofurantoin for the treatment of lower urinary tract infections. Antibiotics"},{"key":"e_1_3_5_28_2","doi-asserted-by":"crossref","first-page":"e00476","DOI":"10.1128\/AAC.00476-17","article-title":"In vivo pharmacokinetics and pharmacodynamics of ZTI-01 (fosfomycin for injection) in the neutropenic murine thigh infection model against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa","volume":"61","author":"Lepak A.J.","year":"2017","unstructured":"Lepak A.J., , Zhao M., , VanScoy B., , Taylor D.S, , Ellis-Grosse E., , Ambrose P.G, , and Andes D.R.. 2017. In vivo pharmacokinetics and pharmacodynamics of ZTI-01 (fosfomycin for injection) in the neutropenic murine thigh infection model against Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Antimicrob. Agents. Chemother. 61:e00476-17.","journal-title":"Antimicrob. Agents. Chemother"},{"key":"e_1_3_5_29_2","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1093\/jac\/dkz519","article-title":"Impact of bacterial species and baseline resistance on fosfomycin efficacy in urinary tract infections","volume":"75","author":"Abbott I.J.","year":"2020","unstructured":"Abbott I.J., , Dekker J., , van Gorp E., , Wijma R.A, , Raaphorst M.N, , Klaassen C.H.W, , Meletiadis J., , Mouton J.W, , and Peleg A.Y.. 2020. Impact of bacterial species and baseline resistance on fosfomycin efficacy in urinary tract infections. J. Antimicrob. Chemother. 75:988\u2013996.","journal-title":"J. Antimicrob. Chemother"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2020.0200","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2020.0200","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2020.0200","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:38:00Z","timestamp":1777667880000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2020.0200"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1089\/mdr.2020.0200"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2020.0200","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}