Fosfomycin

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Information about Fosfomycin

Fosfomycin is an orally available, broad spectrum antibiotic used largely for treatment of uncomplicated urinary tract infections.

Liver safety of Fosfomycin

Fosfomycin is associated with a low rate of transient serum enzyme during therapy and with rare cases of clinically apparent acute liver injury with jaundice.

Mechanism of action of Fosfomycin

Fosfomycin (fos' foe mye. sin) is an oral, broad spectrum bactericidal antibiotic that is typically used as a single, large oral dose to treat acute cystitis. Fosfomycin (also known as phosphomycin) is a natural product of Streptomyces fradiae that acts by inactivation of a bacterial enzyme necessary for cell wall synthesis. Fosfomycin has a unique structure (an analogue of phosphoenolpyruvate) and is structurally unrelated to other antibiotics.

Clinical use of Fosfomycin

It has activity against both gram-positive and gram-negative bacteria and is excreted largely unchanged and in its active form in the urine, making it useful for treatment of urinary tract infections. Antibacterial resistance is, however, frequent with prolonged use.

FDA approval information for Fosfomycin

Fosfomycin was approved for use in the United States in 1997 and current indications are for uncomplicated urinary tract infections caused by susceptible organisms. Fosfomycin is available under the commercial name [Monurol]] in a sachet of 3 grams and is recommended as a single dose.

Dosage and administration for Fosfomycin

intravenous formulations of fosfomycin have been used in combination with carbapenems or aminoglycosides as therapy of multidrug resistant bacterial organisms such as methicillin-resistant Staphyloccocus aureus (MRSA), but it has yet to be approved for this use in the United States. The intravenous formulation is generally given in 1 to 2 gram amounts every 6 hours for 3 to 28 days. Oral fosfomycin is well tolerated.

Side effects of Fosfomycin

Common side effects may include diarrhea, nausea, headache and fungal vaginitis. Rare, but potentially serious adverse events include allergic reactions, anaphylaxis and toxic megacolon.


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