Fosfomycin Brand Name– Monurol
What is Fosfomycin
Fosfomycin is an oral antibiotic used for the treatment of uncomplicated urinary tract infections (UTIs) caused by either E. coli or Enterococcus faecalis.
Fosfomycin is structurally similar to phosphoenolpyruvate, one of the precursors involved in the synthesis of peptidoglycan. Unlike beta-lactams, fosfomycin disrupts the building of bacterial cell walls by blocking formation of cell wall precursors rather than blocking peptide cross-linking.
The combination of fosfomycin and a beta-lactam may be synergistic.
Fosfomycin was originally discovered in 1969 and may be listed as “phosfomycin” in some US references.
It has been available in Europe since 1988. Since it sustains effective urinary concentrations for over 3 days, fosfomycin is approved for single-dose treatment of uncomplicated urinary tract infection, however, efficacy as a single dose agent appears to be less than that for fluoroquinolones or co-trimoxazole.
In vitro data suggest that fosfomycin may also be effective for other UTIs caused by gram-negative rods, however, no clinical data are available at this time to support using fosfomycin in UTIs involving these pathogens.
Fosfomycin was FDA approved December 18, 1996 and is currently available in 19 foreign countries.
Indications
- Citrobacter diversus
- Citrobacter freundii
- cystitis
- Enterococcus faecalis
- Enterococcus faecium
- Escherichia coli
- Klebsiella oxytoca
- Klebsiella pneumoniae
- Proteus mirabilis
- Proteus vulgaris
- Serratia marcescens
- urinary tract infection (UTI)
Side Effects
- abdominal pain
- anaphylactoid reactions
- angioedema
- anorexia
- aplastic anemia
- asthenia
- back pain
- constipation
- diarrhea
- dizziness
- drowsiness
- dysmenorrhea
- dyspepsia
- dysuria
- elevated hepatic enzymes
- fever
- flatulence
- headache
- hearing loss
- hematuria
- hepatic necrosis
- infection
- influenza
- insomnia
- jaundice
- lymphadenopathy
- migraine
- myalgia
- nausea
- optic neuritis
- paresthesias
- pharyngitis
- pruritus
- pseudomembranous colitis
- rash
- rhinitis
- superinfection
- toxic megacolon
- vaginitis
- vomiting
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- breast-feeding
- children
- colitis
- diarrhea
- geriatric
- GI disease
- infants
- inflammatory bowel disease
- neonates
- pregnancy
- pseudomembranous colitis
- ulcerative colitis
Interactions
- Bethanechol
- Cisapride
- Metoclopramide
- Prucalopride