Oral Fosfomycin for the Treatment of Acute and Chronic Bacterial Prostatitis Caused by Multidrug-Resistant Escherichia coli

Table 1

In vitro activities of orally prescribed antimicrobial agents against urine isolates of E. coli collected by 15 clinical laboratories across Canada from 2007 to 2015^a.

E. coli phenotype^b (n)	Antimicrobial agent	CLSI MIC interpretation^f
		% S	% I	% R
All E. coli (1,207)	Fosfomycin	99.2	0.7	0.1
	AMC^c	87.1	9.6	3.3
	Ciprofloxacin	81.1	0	18.9
	TMP-SMX^d	75	—	25
TMP-SMX-resistant (302)	Fosfomycin	99.7	1.3	1
	AMC	74.8	22.2	3
	Ciprofloxacin	57.6	0	42.4
	TMP-SMX	0	0	100
Ciprofloxacin-resistant (228)	Fosfomycin	96.1	0.4	3.5
	AMC	71.5	22.8	5.7
	Ciprofloxacin	0	100	100
	TMP-SMX	43.9	—	56.1
ESBL-positive (61)	Fosfomycin	95.1	4.9	0
	AMC	63.9	32.8	3.3
	Ciprofloxacin	16.4	0	83.6
	TMP-SMX	34.4	—	65.6
AMC-resistant (40)	Fosfomycin	100	0	0
	AMC	0	0	100
	Ciprofloxacin	67.5	0	32.5
	TMP-SMX	77.5	—	22.5
Resistant to TMP-SMX and CIP^e (128)	Fosfomycin	97.7	0.7	1.6
	AMC	66.4	28.9	4.7
	Ciprofloxacin	0	0	100
	TMP-SMX	0	0	100
Resistant to CIP and AMC (13)	Fosfomycin	100	0	0
	AMC	0	0	100
	Ciprofloxacin	0	0	100
	TMP-SMX	53.8	—	46.2
Resistant to TMP-SMX and AMC (9)	Fosfomycin	100	0	0
	AMC	0	0	100
	Ciprofloxacin	33.3	0	66.7
	TMP-SMX	0	0	100
Multidrug-resistant (12)	Fosfomycin	100	0	0
	AMC	16.7	33.3	50
	Ciprofloxacin	0	0	100
	TMP-SMX	0	0	100

^aData adapted from reference [4]; ^bESBL, extended-spectrum β-lactamase; multidrug-resistant was defined as isolates resistant to ≥3 agents from different antimicrobial classes (amoxicillin-clavulanate, ciprofloxacin, nitrofurantoin, and TMP-SMX); ^cAMC, amoxicillin-clavulanate; ^dTMP-SMX, trimethoprim-sulfamethoxazole; ^eCIP, ciprofloxacin; ^fbased on CLSI fosfomycin MIC breakpoints for E. coli: susceptible, ≤64 μg/mL; intermediate, 128 μg/mL; and resistant, ≥256 μg/mL (CLSI, M100-S26, 2016).