Part III: Guidelines for Selected Antimicrobial Use

3.6 Fosfomycin trometamol

1. A low-molecular-weight phosphoric acid derivative antibiotic which inhibits bacterial cell wall synthesis. [231]

2. In vitro activity against a variety of Gram-positive and Gram-negative bacteria, including Escherichia coli and Staphylococcus aureus. [232]

3. Acinetobacter species, Burkholderia cepacia, Bacteroides species, Morganella morganii, Pseudomonas species, Stenotrophomonas maltophilia, Staphylococcus capitis, and Staphylococcus saprophyticus are intrinsically resistant to fosfomycin. [232,233]

4. Oral fosfomycin trometamol (3 g in a single dose) can be a treatment choice for acute uncomplicated urinary tract infection in premenopausal, non-pregnant women with no known urological abnormalities or co-morbidities, although it appears to have inferior efficacy compared to other standard therapy. [234–237]

5. Adverse reactions (non-exhaustive)

6. For treatment of infections other than uncomplicated cystitis, please consult a clinical microbiologist or infectious disease physician regarding the use of fosfomycin.