Project Details

Towards patient-friendly and future-proof treatment of pediatric bacterial infections - Unraveling the pharmacokinetics of Fosfomycin

Matthijs Kruizinga, MD, PhD

Summary

BACKGROUND: Urinary tract infections (UTIs) are one of the most common bacterial infections in children, contributing significantly to pediatric morbidity and healthcare burden globally. The increasing prevalence of multi-drug resistant (MDR) organisms complicates the management of UTIs, leading to longer hospital stays, increased healthcare costs, and poorer clinical outcomes. GAP: Among the potential candidates for repurposing older antibiotics, fosfomycin stands out as an intriguing option. Originally developed in the 1960s, fosfomycin is a broad-spectrum antibiotic with activity against both gram-positive and gram-negative bacteria (including many MDR strains4) and excellent tissue penetration (including into renal and bone tissue). However, there is a complete lack of any pharmacokinetic data regarding fosfomycin in children HYPOTHESIS: Develop a population pharmacokinetic model for oral fosfomycin in children and develop age-appropriate dosing regimens for all pediatric age groups. METHODS: This will be a prospective, open-label pharmacokinetic study involving 30 pediatric patients aged 1 month – 12 years with suspected or confirmed UTIs. The primary outcome is the characterization of oral fosfomycin pharmacokinetics via a population pharmacokinetic model. RESULTS: Pending. IMPACT: This study will generate the first pediatric-specific pharmacokinetic data for oral fosfomycin, enabling evidence-based dosing recommendations that will immediately improve the evidence base for treatment and may improve treatment outcomes. It will also lay the groundwork for future studies exploring expanded indications and combination therapies (for MDR bacteria) in children.