Fosfomycin Tromethamine and Electrolyte losses

• Generic Name: fosfomycin
• Dosage Forms: n.a.
• Other Brand Names: Monurol

Treatment of uncomplicated UTIs (acute cystitis) in women caused by susceptible Escherichia coli or Enterococcus faecalis (formerly Streptococcus faecalis).

Oral fosfomycin (single 3-g dose) is one of several preferred anti-infectives for empiric treatment of uncomplicated cystitis in women. Considered a good choice for such infections since incidence of fosfomycin resistance among uropathogens (e.g., E. coli) is low to date and the single-dose regimen is well tolerated and has not been associated with selection of drug-resistant bacteria or colonization/infection with multidrug-resistant strains.

Has been used (single dose or multiple doses) for treatment of UTIs caused by multidrug-resistant bacteria and some clinicians suggest it may be a viable option for treatment of such infections; however, additional study needed.

Do not use for treatment of pyelonephritis or perinephric abscesses. Avoid if diagnostic uncertainty exists regarding cystitis versus early pyelonephritis (e.g., cystitis symptoms accompanied by subjective fever [not verified at time of examination] and/or vague flank pain or tenderness, cystitis symptoms present for >5–7 days).

Has been effective when used in a limited number of men for treatment of chronic prostatitis caused by multidrug-resistant Enterobacteriaceae (e.g., E. coli). However, treatment failures also reported and further study needed to evaluate efficacy and safety of oral fosfomycin for treatment of chronic prostatitis and to identify optimal dosage and duration of fosfomycin treatment for such infections.

Has been effective when used for perioperative prophylaxis in men undergoing transrectal biopsy of the prostate.

Has been effective when used for perioperative prophylaxis in men undergoing transurethral resection of the prostate for benign prostatic hyperplasia.

Additional study needed to evaluate efficacy and safety and optimal timing for perioperative prophylaxis in men undergoing transrectal biopsy of the prostate or transurethral resection of the prostate.