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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 in UTI during pregnancy, 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.

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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