Uso de fosfomicina comparado con ceftriaxona y meropenem para el tratamiento de las infecciones urinarias por Escherichia coli multirresistente (estudio FOREST): Valoración crítica del artículo.

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Title: Uso de fosfomicina comparado con ceftriaxona y meropenem para el tratamiento de las infecciones urinarias por Escherichia coli multirresistente (estudio FOREST): Valoración crítica del artículo.
Alternate Title: Use of fosfomycin compared with ceftriaxone and meropenem for the treatment of urinary tract infections due to multidrug-resistant Escherichia coli (the FOREST study): Critically appraised article.
Authors: Zela-Coila, Frank1 fzela@unsa.edu.pe, Vizcarra-Jiménez, Sonia2,3 sofer.vj@gmail.com, Taype-Rondan, Alvaro4,5 alvaro.taype.r@gmail.com
Source: Revista del Cuerpo Médico del Hospital Nacional Almanzor Aguinaga Asenjo. 2023, Vol. 16 Issue 3, p1-11. 11p.
Abstract (English): Presentation: In this article, we present our critical assessment of a pragmatic clinical trial published in the Jama Network Open journal in the year 2022. Study conclusions: The study fails to demonstrate the non-inferiority of 4g of intravenous disodium fosfomycin every 6 hours over 60 minutes compared to ceftriaxone (1g of intravenous ceftriaxone every 24 hours over 2-4 minutes) or, if resistant to ceftriaxone, meropenem (1g of intravenous meropenem every 8 hours over 15-30 minutes). Critical comment: The article is relevant because bacterial resistance is currently of interest for the proper management of urinary tract infections. Therefore, alternatives that are not empirically used are being sought. However, the study has limitations such as not reaching the calculated sample size, having a low margin of noninferiority, and the lack of blinding in the intervention. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Presentación: En el presente artículo exponemos nuestra valoración crítica de un ensayo clínico pragmático FOREST sobre manejo de infecciones de tracto urinario bacteriémicas publicado en la revista Jama Network Open el año 2022. Conclusiones del estudio: En el estudio no se logra demostrar la no inferioridad de la fosfomicina disódica de 4g cada 6 horas por vía intravenosa en 60 minutos frente a ceftriaxona (1 g cada 24 horas por vía intravenosa en 2-4 minutos) o si fuera resistente a esta, meropenem (1 g cada 8 horas por vía intravenosa en 15-30 minutos). Comentario crítico: El artículo analizado es relevante porque actualmente la resistencia bacteriana resulta de interés para un manejo adecuado de las infecciones de tracto urinario, por ello se buscan alternativas que no sean de uso empírico. Sin embargo, presenta limitaciones como no alcanzar el tamaño de muestra calculado, tener un margen de no inferioridad bajo y la falta de cegamiento en la intervención. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
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Abstract:Presentation: In this article, we present our critical assessment of a pragmatic clinical trial published in the Jama Network Open journal in the year 2022. Study conclusions: The study fails to demonstrate the non-inferiority of 4g of intravenous disodium fosfomycin every 6 hours over 60 minutes compared to ceftriaxone (1g of intravenous ceftriaxone every 24 hours over 2-4 minutes) or, if resistant to ceftriaxone, meropenem (1g of intravenous meropenem every 8 hours over 15-30 minutes). Critical comment: The article is relevant because bacterial resistance is currently of interest for the proper management of urinary tract infections. Therefore, alternatives that are not empirically used are being sought. However, the study has limitations such as not reaching the calculated sample size, having a low margin of noninferiority, and the lack of blinding in the intervention. [ABSTRACT FROM AUTHOR]
ISSN:22255109
DOI:10.35434/rcmhnaaa.2023.163.1948