Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial

Purpose: A post hoc analysis of data from a previously published clinical trial was conducted using the desirability of outcome ranking (DOOR) methodology with the aim provide additional information on the use of fosfomycin for the treatment of bacteraemic urinary tract infection (BUTI) caused by mu...

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Autores: Sojo-Dorado, Jesús, López-Hernández, Inmaculada, Gutiérrez Gutiérrez, Belén, Rosa-Riestra, Sandra, Docobo Pérez, Fernando, Hernánez-Torres, Alicia, Pascual Hernández, Álvaro, Rodríguez-Baño, Jesús
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2024
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/175293
Acceso en línea:https://hdl.handle.net/11441/175293
https://doi.org/10.1080/23744235.2024.2435565
Access Level:acceso abierto
Palabra clave:Desirability of outcome ranking (DOOR)
Escherichia coli
Fosfomycin
Urinary tract infection.
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spelling Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trialSojo-Dorado, JesúsLópez-Hernández, InmaculadaGutiérrez Gutiérrez, BelénRosa-Riestra, SandraDocobo Pérez, FernandoHernánez-Torres, AliciaPascual Hernández, ÁlvaroRodríguez-Baño, JesúsDesirability of outcome ranking (DOOR)Escherichia coliFosfomycinUrinary tract infection.Purpose: A post hoc analysis of data from a previously published clinical trial was conducted using the desirability of outcome ranking (DOOR) methodology with the aim provide additional information on the use of fosfomycin for the treatment of bacteraemic urinary tract infection (BUTI) caused by multi-drug-resistant (MDR) E. coli. Methods: Three DOOR systems with five, six and seven categories, respectively were developed. Safety and efficacy were prioritised in all rankings, but step down to oral therapy and exposure to antibiotics with lower ecological impact were also considered in DOOR-6 and DOOR-7. The probability that a patients assigned to fosfomycin was classified into a more desirable outcome category was calculated for the three DOOR definitions. Subgroups analyses and an ordinal logistic regression model were also performed. Results: Data from 143 participants were analysed. The probability of having a more desirable outcome after treatment with fosfomycin versus the comparators was 0.44 (95% CI 0.36 - 0.52) for DOOR-5; 0.50 (95% IC 0.42 - 0.58) using DOOR-6 and 0.61 (95% CI 0.53-0.69) with DOOR-7. In subgroups, the highest probability of having a better DOOR with fosfomycin was seen in the clinically evaluable population and among patients without chronic heart disease or renal insufficiency for the DOOR-7 definition. Conclusions: DOOR analysis could be applied to the FOREST trial data; the results were somehow different for the different DOOR systems used. Overall, fosfomycin was favoured when oral step-down treatment and use of antibiotics with lower ecological impact were included.Taylor & Francis LtdMedicinaMicrobiologíaBIO210: Microorganismos EucariotasEuropean Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)Instituto de Salud Carlos IIIGobierno de España2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/175293https://doi.org/10.1080/23744235.2024.2435565reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésInfectious Diseases, 57 (3), 294-300.PI 13/01282https://www.tandfonline.com/doi/full/10.1080/23744235.2024.2435565info:eu-repo/semantics/openAccessoai:idus.us.es:11441/1752932026-06-17T12:51:07Z
dc.title.none.fl_str_mv Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
title Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
spellingShingle Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
Sojo-Dorado, Jesús
Desirability of outcome ranking (DOOR)
Escherichia coli
Fosfomycin
Urinary tract infection.
title_short Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
title_full Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
title_fullStr Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
title_full_unstemmed Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
title_sort Fosfomycin in bacteraemic urinary tract infection due to multidrug-resistant Escherichia coli: insights of post hoc DOOR analysis of the FOREST trial
dc.creator.none.fl_str_mv Sojo-Dorado, Jesús
López-Hernández, Inmaculada
Gutiérrez Gutiérrez, Belén
Rosa-Riestra, Sandra
Docobo Pérez, Fernando
Hernánez-Torres, Alicia
Pascual Hernández, Álvaro
Rodríguez-Baño, Jesús
author Sojo-Dorado, Jesús
author_facet Sojo-Dorado, Jesús
López-Hernández, Inmaculada
Gutiérrez Gutiérrez, Belén
Rosa-Riestra, Sandra
Docobo Pérez, Fernando
Hernánez-Torres, Alicia
Pascual Hernández, Álvaro
Rodríguez-Baño, Jesús
author_role author
author2 López-Hernández, Inmaculada
Gutiérrez Gutiérrez, Belén
Rosa-Riestra, Sandra
Docobo Pérez, Fernando
Hernánez-Torres, Alicia
Pascual Hernández, Álvaro
Rodríguez-Baño, Jesús
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Medicina
Microbiología
BIO210: Microorganismos Eucariotas
European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER)
Instituto de Salud Carlos III
Gobierno de España
dc.subject.none.fl_str_mv Desirability of outcome ranking (DOOR)
Escherichia coli
Fosfomycin
Urinary tract infection.
topic Desirability of outcome ranking (DOOR)
Escherichia coli
Fosfomycin
Urinary tract infection.
description Purpose: A post hoc analysis of data from a previously published clinical trial was conducted using the desirability of outcome ranking (DOOR) methodology with the aim provide additional information on the use of fosfomycin for the treatment of bacteraemic urinary tract infection (BUTI) caused by multi-drug-resistant (MDR) E. coli. Methods: Three DOOR systems with five, six and seven categories, respectively were developed. Safety and efficacy were prioritised in all rankings, but step down to oral therapy and exposure to antibiotics with lower ecological impact were also considered in DOOR-6 and DOOR-7. The probability that a patients assigned to fosfomycin was classified into a more desirable outcome category was calculated for the three DOOR definitions. Subgroups analyses and an ordinal logistic regression model were also performed. Results: Data from 143 participants were analysed. The probability of having a more desirable outcome after treatment with fosfomycin versus the comparators was 0.44 (95% CI 0.36 - 0.52) for DOOR-5; 0.50 (95% IC 0.42 - 0.58) using DOOR-6 and 0.61 (95% CI 0.53-0.69) with DOOR-7. In subgroups, the highest probability of having a better DOOR with fosfomycin was seen in the clinically evaluable population and among patients without chronic heart disease or renal insufficiency for the DOOR-7 definition. Conclusions: DOOR analysis could be applied to the FOREST trial data; the results were somehow different for the different DOOR systems used. Overall, fosfomycin was favoured when oral step-down treatment and use of antibiotics with lower ecological impact were included.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/175293
https://doi.org/10.1080/23744235.2024.2435565
url https://hdl.handle.net/11441/175293
https://doi.org/10.1080/23744235.2024.2435565
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Infectious Diseases, 57 (3), 294-300.
PI 13/01282
https://www.tandfonline.com/doi/full/10.1080/23744235.2024.2435565
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Taylor & Francis Ltd
publisher.none.fl_str_mv Taylor & Francis Ltd
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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