Clinical Experience on the Use of Faropenem in Indian Patients with Urinary Tract Infections

Background: Urinary tract infections (UTIs) are a common infectious disorders affecting both men and women. India has the highest rate of extended-spectrum beta-lactamase (ESBL)-producing microbes worldwide. Faropenem (FRPM) is a suitable antibiotic, belonging to the penem group of β-lactam antibiotics that can be taken orally. Faropenem has little practical clinical experience at the urologists level and lacks real-world evidence.

Methods: A questionnaire-based survey was conducted from Indian urologists. The study collects data to understand the appropriate use of FRPM in Indian patients with UTIs in the real-world setting in India. The study focuses on the utility of FRPM in UTI; prevalence of UTI with other comorbidities such as type 2 diabetes mellitus (T2DM) and benign prostate hypertrophy (BPH), prescription trends among urologists for UTIs, other antibiotics along with FRPM, response to stepdown therapy in UTI and response in elderly patients with UTI.

Result: A total of 49 urologists participated in the study and a surveillance form with 16 structured questions was formulated. Data from their responses showed that of the 10 patients treated with FRPM, largest proportion (46.94%) of patients had history recent recurrent UTI and 40 physicians agreeing than more than 3 (81.63%) out of 10 patients treated with FRPM had UTI and diabetes. E. coli was the most prevalent pathogen in causing UTI as per past lab reports (73.47%) Significant majority were treated with other antibiotics before seeking FRPM and specifically fluoroquinolones (44.90%) were the preferred antibiotics prior to prescribing FRPM. 97.96% of respondents indicated of using FRPM as sequential therapy during step-down treatment after imipenem cilastatin or meropenem in hospitalized patients and they continued to be asymptomatic and infection resolved completely after step-down therapy with oral FRPM. A higher percentage (44.90%) of respondents could be ESBL producers and more than half of them indicated of prescribing FRPM as the first drug of choice. Vast majority (93.88%) of elderly patients tolerated FRPM well and overall, 38.77% indicated patient underwent complete cure with FRPM. 

Conclusion: Faropenem is well tolerated and clinically effective in treating UTIs even in elderly patients and as a step-down therapy. Several urologists use it in complicated UTIs or in cases when other antibiotics fail to treat the infection. It can be considered as a first choice after the susceptibility data is analyzed.