Fosfomycin for post-renal transplant urinary tract infection: Re-emergence of an old drug - A case report

Abstract

Urinary tract infection (UTI) is a common problem in renal transplant recipients (RTR). It is challenging to treat UTI in RTR, as they are immunosuppressed, prone to allograft dysfunction, and can have adverse drug interactions due to the concomitant use of other immunosuppressant drugs. The UTI in RTR may present as asymptomatic bacteriuria (ASB), cystitis, pyelonephritis, or asymptomatic allograft dysfunction. Many times, UTI is caused by drug-resistant organisms, making it difficult to treat and also limiting the choice of empirical and specific antimicrobial therapy. Besides this, the treatment of ASB is controversial in RTR. Fosfomycin is an old drug which is re-emerging as an empirical antibiotic for UTI. Herein, we report a patient with multidrug-resistant ASB, within 1st month of transplant treated successfully with a single dose of fosfomycin.