Drug Breakdown: Fosfomycin
Abstract
In this column, Sharon Rees aims to refresh knowledge and interest in some of the commonly used drugs in a series of tweets. This month she is talking about #fosfomycin
Day 1: Originally derived from streptomyces bacteria (1960s), the main use for the synthetic oral form of #fosfomycin since the 1990s is for uncomplicated UTIs. Still available i.v for osteomyelitis, RTI & complicated UTIs
Day 2: #fosfomycin is used 2nd–3rd line for uncomplicated UTI as the oral formulation of #fosfomycin trometamol. This is a single dose therapy 3 g for those over 12yrs. SPC also states used for peri-operative prophylaxis in transrectal prostate biopsy in men. Granules are dissolved in water & taken stat
Day 3: #fosfomycin should be taken on an empty stomach at bedtime & after emptying bladder. There is no known drug metabolism. #fosfomycin is distributed into the urinary tract in high concentrations. Unchanged drug is excreted in urine for minimum 24 hrs, hence single dose. T½ ~ 6 hrs. This is prolonged in severe renal failure (do not use)
Day 4: #fosfomycin MOA is to inactivate the MurA enzyme needed for peptidoglycan/cell wall synthesis. Rapid bactericidal effect with low toxicity. Covers a wide spectrum of bacteria including some resistant organisms e.g MRSA, ESBL organisms & glycopeptide resistant enterococci
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