Combination therapy with fosfomycin for Staphylococcus aureus bacteraemia or endocarditis: a systematic review and meta-analysis of randomized trials Article Swipe
Ahmad Mourad
,
Joshua B. Parsons
,
Lesley A. Skalla
,
Thomas L Holland
,
Timothy C Jenkins
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/jacamr/dlaf101
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/jacamr/dlaf101
Background and objectives Fosfomycin combination therapy for Staphylococcus aureus bacteraemia or endocarditis has been evaluated, but studies were limited by small sample sizes. We sought to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to establish robust efficacy and safety estimates of fosfomycin combination therapy in this patient population. Data sources MEDLINE, Embase, Cochrane Library and Web of Science databases were searched from inception through September 2024 (PROSPERO CRD42024583822). Study eligibility RCTs comparing fosfomycin combination with standard-of-care antibiotics in patients with S. aureus bacteraemia or endocarditis were included. Two independent reviewers screened studies for inclusion. Assessment of risk of bias Risk of bias was assessed using the revised Cochrane RoB 2 tool. Data synthesis and analysis Treatment effects were estimated with pooled risk ratios (RRs) using random effects meta-analysis. Heterogeneity between studies was assessed with Cochran's Q-statistic and I2 test. Results Of 437 articles identified, three RCTs met inclusion criteria. Primary outcome of treatment success or cure was not meta-analysed due to clinical heterogeneity. Combination therapy did not significantly improve mortality (RR 0.85; 95% CI, 0.28–2.52; I2 = 27.8%) or persistent bacteraemia (RR 0.34; 95% CI, 0.04–2.59; I2 = 0%). Participants receiving combination therapy had more adverse events leading to treatment discontinuation, but this was not statistically significant (RR 1.84; 95% CI, 0.36–9.36; I2 = 18%). Conclusions In this meta-analysis of three RCTs, fosfomycin combination therapy for S. aureus bacteraemia or endocarditis did not significantly improve patient outcomes and may be associated with higher rates of adverse events.
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Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1093/jacamr/dlaf101
- https://academic.oup.com/jacamr/article-pdf/7/3/dlaf101/63502364/dlaf101.pdf
- OA Status
- gold
- Cited By
- 2
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4411686687
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4411686687Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/jacamr/dlaf101Digital Object Identifier
- Title
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Combination therapy with fosfomycin for Staphylococcus aureus bacteraemia or endocarditis: a systematic review and meta-analysis of randomized trialsWork title
- Type
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-04-29Full publication date if available
- Authors
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Ahmad Mourad, Joshua B. Parsons, Lesley A. Skalla, Thomas L Holland, Timothy C JenkinsList of authors in order
- Landing page
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https://doi.org/10.1093/jacamr/dlaf101Publisher landing page
- PDF URL
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https://academic.oup.com/jacamr/article-pdf/7/3/dlaf101/63502364/dlaf101.pdfDirect link to full text PDF
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://academic.oup.com/jacamr/article-pdf/7/3/dlaf101/63502364/dlaf101.pdfDirect OA link when available
- Concepts
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Medicine, Fosfomycin, Meta-analysis, Internal medicine, Randomized controlled trial, Cochrane Library, Endocarditis, Relative risk, Discontinuation, Combination therapy, Adverse effect, Intensive care medicine, Antibiotics, Confidence interval, Microbiology, BiologyTop concepts (fields/topics) attached by OpenAlex
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2Total citation count in OpenAlex
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2025: 2Per-year citation counts (last 5 years)
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26Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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