7-day regimen of faropenem for the treatment of
cystitis 11Hamasuna R, Tanaka K, Hayami H, et al .
Treatment of acute uncomplicated cystitis with faropenem for 3 days
versus 7 days: Multicentre, randomized, open-label, controlled
trial. J Antimicrob Chemother. 2014;69(6):1675–1680.
Acute uncomplicated cystitis is a common disease in women, and the
increasing prevalence of resistant bacteria including ESBL-producing
strains in pathogens causing acute uncomplicated cystitis has been of
concern. Hamasuna, et al ., evaluated the efficacy of faropenem
against cystitis, and compared 3- and 7-day administration regimens in a
multicenter, randomized, controlled, open-label study. Women aged ≥20
years, with any cystitis symptoms, such as micturition pain, urinary
frequency, urge to urinate, or lower abdominal pain with pyuria and
bacteriuria were included in this study. The target bacteria wereStaphylococcus spp., Enterococcus faecalis ,Streptococcus agalactiae and Enterobacteriaceae. Faropenem sodium
was administered three times daily (600 mg/day) for 3 days (n=97) or 7
days (n=103).
Clinical efficacy in the two groups was not significantly different when
evaluated at 5–9 days after treatment completion, and at 4–6 weeks
after treatment completion. The microbiological non-recurrence rate was
80.8% (21/26) in the 3-day treatment group and 79.4% (27/34) in the
7-day treatment group (p=1.0). The MIC90 for E.
coli, K. pneumoniae, Staphylococcus and Enterococcus was 1, 0.5, 1 and
0.03 mg/L, respectively. Adverse events (AEs) were reported in 9.5% of
patients (19/200) and there was no significant difference between the 3-
and 7-day treatment groups. The most common AE was diarrhea (7.5%,
15/200). AE severity was mild-to-moderate.
The 7-day regimen of faropenem showed a superior rate of microbiological
response. E. coli strains were, in general, susceptible to faropenem,
including fluoroquinolone- and cephalosporin-resistant strains.
Faropenem for patients with acute cystitis caused by
ESBL-producing E.coli
Fujino et al retrospectively reviewed the medical charts of patients
with acute cystitis caused by ESBL-producing E. coli who were treated
with the oral antimicrobial agent faropenem (FRPM) in their institution
from June 2011 to May 2015.22Fujino, Keiko et al. The efficacy
of faropenem for patients with acute cystitis caused by
extended-spectrum β-lactamase producing Escherichia coli. Journal of
Infection and Chemotherapy, Volume 23, Issue 5, 336 - 338 Ten
patients with acute cystitis caused by ESBL-producing E.coli were
treated with FRPM. Although a clinical cure was achieved in 9 of them,
it reoccurred in 3. This study revealed that the treatment regimen with
FRPM for patients with acute cystitis caused by ESBL-producing E.coli is
promising. However, a non-negligible number of recurrences were caused
by ESBL-producing E.coli
because of the nature of underlying diseases or pathologies in the
urinary tract.
Faropenem for the management of urinary tract infection:
Real-world experience from India. 33Shah A, Sharma S,
Unnikrishnan TK. Experience of Faropenem for the management of
urinary tract infection: Real-world experience from India. IP J Urol
Nephrol Hepatol Sci 2020;3(4):
To record the real-world evidence on the use of faropenem in the
management of UTIs, the responses of Indian urologists were obtained on
the usage of faropenem in the management of complicated urinary tract
infection (cUTI) after providing a set of eight questions having both
multiple-choice responses and open-ended answers. Results :
Responses from 391 participants were collected. In the majority of the
urology clinics prevalence of cUTI was 5-10% whereas others found it to
be 10-20%. A majority believed that faropenem was an effective
pharmacotherapy for the management of UTIs (66.4%) including cUTI as a
step-down therapy (66.4%). Faropenem 300 mg provided more compliance.
The overall perception of the use of faropenem in their practice was
that (out of 391 responses) the majority found it to be effective
(72.7%) and 4.6% of participants have used faropenem as an alternative
for cUTI. The majority found it safe (68.5) to be used in cUTI. It was
shown that faropenem was preferred for the treatment of urinary tract
infections due to its effectiveness, ability to cause less resistance
and safety profile.
A faropenem regimen of 200–300 mg twice daily is recommended by
Medindia for treating genitourinary infections.44Gandra S,
Takahashi S, Mitrani-Gold FS, Mulgirigama A, Ferrinho DA. A systematic
scoping review of faropenem and other oral penems: treatment of
Enterobacterales infections, development of resistance and
cross-resistance to carbapenems. JAC-Antimicrobial Resistance. 2022
Dec;4(6):dlac125.
Farpenem as an alternative to cefuroxime for the treatment of
acute bacterial sinusitis
Siegert, et al ., compared the efficacy and safety of 7-day
courses of faropenem medoxomil (300 mg twice daily; n=228) and
cefuroxime axetil (250 mg twice daily; n=224) in adult patients with
acute bacterial sinusitis in a prospective, multinational, multicenter,
double-blind, comparative study.55Siegert R, Berg O, Gehanno P,et al . Comparison of the efficacy and safety of faropenem
daloxate and cefuroxime axetil for the treatment of acute bacterial
maxillary sinusitis in adults. Eur Arch Otorhinolaryngol.
2003;260(4):186–194.
S. pneumoniae , H. influenzae , S. aureus andM. catarrhalis were the most common organisms isolated at
baseline. Four out of 36 H. influenzae , 9 out of 10 M.
catarrhalis and 11 out of 19 S. aureus strains were β-lactamase
producers. At 7–16 days post-therapy, clinical cure was reported in
89.0% of faropenem medoxomil- and 88.4% of cefuroxime axetil-treated
patients, while the corresponding rates for bacteriological success were
91.5% and 90.8%. Eradication or presumed eradication (bacteriological
response) is described in Figure 5. AEs were reported by 46 (16.8%) of
the faropenem medoxomil-treated patients and 49 (17.9%) of the
cefuroxime axetil-treated patients.
In a study by Upchurch, et al ., the efficacy and safety of
faropenem medoxomil was compared with cefuroxime axetil in adults with
acute bacterial sinusitis. This phase III, prospective, randomized,
double-blind, multicenter trial included patients aged ≥18 years with a
clinical diagnosis of acute sinusitis and duration of signs and symptoms
>7 days but <28 days. Patients were randomly
assigned in a 1:1:1 proportion to faropenem medoxomil 300 mg twice daily
for 7 days (n=366) or 10 days (n=363) or cefuroxime axetil 250 mg twice
daily for 10 days (n=370).66Upchurch J, Rosemore M, Tosiello R,et al . Randomized double-blind study comparing 7- and 10-day
regimens of faropenem medoxomil with a 10-day cefuroxime axetil
regimen for treatment of acute bacterial sinusitis. Otolaryngol Head
Neck Surg. 2006;135(4):511–517.
Clinical cure rates for the 7-day and 10-day faropenem medoxomil
regimens were non-inferior to that of the 10-day cefuroxime axetil
regimen for the efficacy-valid population. The continued cure rates at
the late follow-up visit showed that both faropenem medoxomil regimens
had higher success rates than cefuroxime axetil. At least one AE was
reported by 39%, 34% and 41% of patients in the faropenem medoxomil
7-day and 10-day groups and the cefuroxime axetil group, respectively.
The majority of the AEs were mild or moderate in severity (∼87%) and
improved or resolved after treatment.