Fosfomycin: Treatment of Urinary Tract Infections
Mechanism of Action of Fosfomycin
Fosfomycin is a derivative of phosphonic acid and acts by inhibiting the bactericidal cell wall synthesis. Fosfomycin can be administered orally with a single megadose. The substance constitutes a separate pharmacological class of antibiotics.
Indications for Fosfomycin
- Antibiotic spectrum of fosfomycin: Escherichia coli, Citrobacter, Enterobacter, Klebsiella, Serratia, and Enterococcus spp. Fosfomycin lacks activity against Pseudomonas.
- Urological indications: uncomplicated bladder infections of women.
Side Effects of Fosfomycin
Fosfomycin is generally well tolerated. Rarely: rashes, acute hypersensitivity reactions, vomiting, anorexia, diarrhea, liver enzyme elevation, headache, dizziness, fatigue.
Contraindications of fosfomycin:
- Children
- Pregnancy (disputed: may be given, if better alternatives are not available)
- Renal failure
Dosage of Fosfomycin
Fosfomycin is given in single oral dose of 3 g to treat uncomplicated urinary tract infection (Patel et al, 1997) (Stein, 1998).
Trade names of Fosfomycin:
Infectofos, Monuril, Monurol.
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References
- Patel u.a. 1997 PATEL, S. S. ; BALFOUR, J. A. ; BRYSON, H. M.:
- Fosfomycin tromethamine. A review of its antibacterial activity,
pharmacokinetic properties and therapeutic efficacy as a single-dose oral
treatment for acute uncomplicated lower urinary tract infections.
In: Drugs
53 (1997), Nr. 4, S. 637–56
- Simon und Stille 1997 SIMON, C. ; STILLE, W.:
- Antibiotika-Therapie in Klinik und Praxis.
9. Auflage.
Stuttgart New York : Schattauer, 1997
- Stein 1998 STEIN, G. E.:
- Single-dose treatment of acute cystitis with fosfomycin tromethamine.
In: Ann Pharmacother
32 (1998), Nr. 2, S. 215–9
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