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Part III: Guidelines for selected antimicrobial use

3.6 Fosfomycin trometamol

  1. Indications
    • Indicated for treatment of complicated or uncomplicated urinary tract infections caused by ESBL-producing Enterobacteriaceae.
    • Systematic review showed 96.8% of ESBL-producing E. coli isolates and 81.3% of ESBL-producing Klebsiella pneumoniae isolates were susceptible to fosfomycin (159).
  2. Also active against enterococci and MRSA. (160–161)
  3. Dosage:
    • Uncomplicated urinary tract infection: 3 g sachet P.O. for 1 dose with/without food.
    • Complicated urinary tract infection: 3 g sachet P.O. every 2–3 days (up to 21 days) on an empty stomach.
  4. Please consult clinical microbiologist or infectious disease physician for the use of fosfomycin disodium in treatment of infections other than uncomplicated cystitis.