STUDIES ON THE COMBINATION THERAPY OF FOSFOMYCIN AND DIBEKACIN IN COMPLICATED URINARY TRACT INFECTIONS

Clinical efficacy of combination therapy with fosfomycin (FOM) and dibekacin (DKB) was studied in patients with complicated urinary tract infection (UTI). Of the 55 patients accumulated from 7 urology institutes, 39 patients who had pyuria of 5 or more white blood cells per high power field, bacteriuria of 10[4] or more• bacteria per ml of urine and underlying urinary diseases were evaluated for clinical efficacy. Patients received 4g of intravenous FOM and 100 or 200mg of intramuscular DKB a day for 5 to 7 days. The overall clinical efficacy of treatment was evaluated by the criteria proposed by the UTI Committee in Japan as excellent, moderate or poor. Of the 39 patients evaluated for clinical efficacy, 13 patients (33.3%) were infected with multiple organisms and 30 patients (76.9%) had indwelling catheters. The overall results of treatment were excellent in 17.9%, moderate in 64.1% and poor in 17.9%, overall effectiveness rate being 82. 1 %. Of the 52 strains isolated from 39 patients, 48 strains (92.3%) were eradicated and only 4 strains (7.7%) persisted. Side effects were recorded in all 55 patients including those excluded from the evaluation of clinical efficacy. Subjective side effects were not observed in any of the 55 patients. Drugrelated aggravations in laboratory test results were observed in 6 patients (10.9%) but most of them were slight and transient changes; the combination of FOM and DKB appeared to be well tolerated. From the results obtained in this study, combination therapy of FOM and DKB seemed useful in the treatment of complicated UTI, especially those due to multiple orgenisms and those associated with indwelling catheters.