{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:31:13Z","timestamp":1787027473995,"version":"build-2736575974"},"reference-count":29,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Fosfomycin, an old antibiotic attracting renewed interest, offers a broad spectrum of activity and unique synergy with other agents. While widely used in severe infections, real-world data on intravenous fosfomycin remain limited. Objectives: This study aimed to describe the clinical and microbiological characteristics of patients treated with intravenous fosfomycin and to analyze its administration modalities in a real-world setting. Methods: A multicenter retrospective cohort study was conducted across five Italian hospitals. Adult patients receiving intravenous fosfomycin between January 2020 and December 2023 were included. Results: We enrolled 393 patients. The median age was 69 years, with most patients (45%) admitted to Critical Care Units. Pneumonia (34%), bloodstream infections (22%), and urinary tract infections (21%) were the most common indications. Gram-negative bacteria, particularly E. coli and P. aeruginosa, were the predominant pathogens. Fosfomycin was used as empirical therapy in 55% of cases and was combined with other agents in almost all cases (99%). The most frequent partners were piperacillin\/tazobactam (21%) and new beta-lactam\/beta-lactamase inhibitor combinations (18%). The median treatment duration was seven days, with most subjects (65%) receiving a fosfomycin dosage regimen of 16 g\/day. Minimum inhibitory concentrations (MICs) values for fosfomycin were available for 61 isolates (15%), with 78.7% (48\/61) showing MIC \u2264 32 mg\/L. C. difficile infection occurred in only 2% of patients. Mortality rates at 30, 60, and 90 days were 21.6%, 26.7%, and 29.3%, respectively. Conclusions: This study provides valuable insights into the real-world use of intravenous fosfomycin.<\/jats:p>","DOI":"10.3390\/antibiotics14040401","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T06:18:36Z","timestamp":1744611516000},"page":"401","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intravenous Fosfomycin for Difficult-to-Treat Infections: A Real-Life Multicentric Study in Italy"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9204-032X","authenticated-orcid":false,"given":"Verena","family":"Zerbato","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8319-635X","authenticated-orcid":false,"given":"Gianfranco","family":"Sanson","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Fusaro","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Gerussi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Sincovich","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiana","family":"Dellai","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Del Fabro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Santa Maria degli Angeli Hospital of Pordenone (AS FO), 33170 Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7988-5419","authenticated-orcid":false,"given":"Nicholas","family":"Geremia","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale \u201cdell\u2019Angelo\u201d, 30174 Venice, Italy"},{"name":"Unit of Infectious Diseases, Department of Clinical Medicine, Ospedale Civile \u201cS.S. Giovanni e Paolo\u201d, 30122 Venice, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8496-1033","authenticated-orcid":false,"given":"Cristina","family":"Maurel","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Giacomazzi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Biasinutto","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Santa Maria degli Angeli Hospital of Pordenone (AS FO), 33170 Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Giorgio","family":"Di Girolamo","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Scrivo","sequence":"additional","affiliation":[{"name":"Rehabilitation Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6529-5653","authenticated-orcid":false,"given":"Venera","family":"Costantino","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Di Santolo","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8206-6841","authenticated-orcid":false,"given":"Marina","family":"Busetti","sequence":"additional","affiliation":[{"name":"Microbiology Unit, Trieste University Hospital (ASUGI), 34125 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9890-7011","authenticated-orcid":false,"given":"Lory Saveria","family":"Croc\u00e8","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2475-8732","authenticated-orcid":false,"given":"Simone","family":"Giuliano","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Crapis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Santa Maria degli Angeli Hospital of Pordenone (AS FO), 33170 Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Zhanel","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0W2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Tascini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Clinic, Azienda Sanitaria Universitaria del Friuli Centrale (ASUFC), 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5546-0715","authenticated-orcid":false,"given":"Roberto","family":"Luzzati","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Di Bella","sequence":"additional","affiliation":[{"name":"Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/j.1469-0691.2011.03636.x","article-title":"Fosfomycin: An Old-New Antibiotic","volume":"18","author":"Raz","year":"2012","journal-title":"Clin. 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Infect."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/4\/401\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:13:59Z","timestamp":1760030039000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/14\/4\/401"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["antibiotics14040401"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics14040401","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]}}}