In this study, the clinical efficacy of
fosfomycin (FOM) for various types of orofacial
infections was evaluated in 40 patients, 27 males and 13 females, ranging in age from 16 to 71 years. All but 1 patients were treated orally with FOM at 500 mg 4 times daily. The total
duration of treatment varied from 3 to 31 days. Basically, clinical effectiveness was determined by the criteria of Japanese Society of Oral and Maxillofacial Surgeons. Two cases, in which the final therapeutic evaluation could not be obtained because of side effects, were excluded from the analysis. The results were rated as excellent in 7, good in 26 and poor in 5 out of 38 evaluable cases, with an efficacy rate reaching 86.8%. From the clinical standpoint, the differences of efficacy were further discussed in terms of phase, type and intensity of
infections respectively. In 9 (10 times) of 40 cases, the bacteriological analyses could be made. The identification of organisms obtained from
abscess in each case demonstrated
mixed infections caused by both aerobic and anaerobic organisms in more than half cases. From their sensitivity tests, it should be pointed out that FOM was efficiently active against aerobic and anaerobic Gram-positive organisms, while it was ineffective for the anaerobic Gram-negative organism, Bacteroides, although the role of the latter generally remained still obscure in orofacial
infection. No serious side effects were observed except for mild
diarrhea in 3 patients and a slight elevation of
serum glutamic oxaloacetic transaminase (GOT) level in 1 patient. This study conclusively demonstrated that FOM was a useful and safe
antibiotic in the treatment of patients with various orofacial
infections.