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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. [234237]

  5. Adverse reactions (non-exhaustive)

Gastrointestinal upsets like diarrhoea are described as common side effects. [238,239]

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