2. Fosfomycin (PO)
Bactericidal agent that is excreted into the urine and inhibits cell wall synthesis by interfering with peptidoglycan synthesis.
Spectrum: Broad spectrum vs Gram positive including MRSA, VRE; Gram negative including Pseudomonas and some ESBL’s .
Used for: Uncomplicated urinary tract infections in women, especially in those with history of resistant bugs. Given as a one-time mega-dose of 3 g (excreted into urine and achieves high levels there for several days. Sometimes used for complicated UTI’s in males with resistant pathogens (3 g PO q3 days x several doses), although this is an off-label use.
Acne is often present. Acne conglobata is a particularly severe form of acne that can develop during steroid abuse or even after the drug has been discontinued. Infections are a common side effect of steroid abuse because of needle sharing and unsanitary techniques used when injecting the drugs into the skin. These are similar risks to IV drug abusers with increased potential to acquire blood-borne infections such as hepatitis and HIV/AIDS . Skin abscesses may occur at injection sites and may spread to other organs of the body. Endocarditis or an infection of the heart valves is not uncommon.
Aspiration pneumonia in adults
Bacterial pulmonary infections in HIV-infected patients
Clinical manifestations and diagnosis of Legionella infection
Clinical presentation and diagnosis of Pneumocystis pulmonary infection in HIV-infected patients
Clinical presentation and diagnostic evaluation of ventilator-associated pneumonia
Community-acquired pneumonia in adults: Assessing severity and determining the appropriate site of care
Diagnostic approach to community-acquired pneumonia in adults
Epidemiology and pathogenesis of Legionella infection
Epidemiology, pathogenesis, and microbiology of community-acquired pneumonia in adults
Epidemiology, pathogenesis, microbiology, and diagnosis of hospital-acquired and ventilator-associated pneumonia in adults
Mycoplasma pneumoniae infection in adults
Pneumococcal pneumonia in adults
Pneumonia caused by Chlamydia pneumoniae in adults
Pseudomonas aeruginosa pneumonia
Risk factors and prevention of hospital-acquired and ventilator-associated pneumonia in adults
Sputum cultures for the evaluation of bacterial pneumonia
Treatment of community-acquired pneumonia in adults in the outpatient setting
Treatment of community-acquired pneumonia in adults who require hospitalization
Treatment of hospital-acquired and ventilator-associated pneumonia in adults
Principles of antimicrobial therapy of Pseudomonas aeruginosa infections
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