Effect of fosfomycin-induced hypernatremia on patients’ hospital stay length and survival

• Published in: Irish journal of medical science Vol. 193; no. 5; pp. 2453 - 2459
• Main Authors: Kollu, Korhan, Bas, Arife, Gok, Funda, Kizilarslanoglu, Muhammet Cemal
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2024
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; Family Medicine; Female; Fosfomycin - adverse effects; Fosfomycin - therapeutic use; General Practice; Humans; Hypernatremia - chemically induced; Hypernatremia - mortality; Intensive Care Units - statistics & numerical data; Internal Medicine; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Retrospective Studies; Sodium - blood; Survival Rate; Hypernatremia; Survival; Fosfomycin; Hospital stay length
• DOI: 10.1007/s11845-024-03718-1
• ISSN: 0021-1265; 1863-4362

Background and objective Hypernatremia is a possible side effect of intravenous fosfomycin. The aim of this study was to investigate the effects of changes in sodium (Na) levels on hospital stay and survival in patients hospitalized in the intensive care unit receiving fosfomycin. Subjects and methods This study was conducted retrospectively on the files of patients over the age of 60, who were admitted to the Internal Medicine Intensive Care Unit. Plasma sodium levels were observed and documented over a period of 14 days. The patients were divided into two groups (Hypernatremia group Na > 145 mEq/L vs normonatremia group 135–145 mEq/L). In addition, daily sodium changes were noted for 14 days in patients. Results The mean age of the patients was 75 years. Hospitalization days were longer for hypernatremia patients (31.5 days vs 41 days, p  = 0.003). Patients with hypernatremia had an extended duration of stay in the intensive care unit. (21 days vs 31 days p  = 0.002). The 1-month survival rate was 61.4% in patients with hypernatremia and 24.9% in patients without hypernatremia ( p  = 0.004). The absence of hypernatremia increases mortality by 2.09 times (95% CI 1.35–3.23). When discharge and mortality rates were analyzed according to sodium fluctuation, discharged patients exhibited a lower sodium fluctuation (4 min/max (−10/19) vs 6 min/max (−16/32) p  < 0.001). Conclusion In conclusion, the strength of our study is that it specifically focuses on the consequences of the sodium fluctuation on patient management and provides results.