Fosfomycin, Single-dose Oral Antibiotic for Uncomplicated UTI – A Review

Abstract

Urinary tract infections (UTIs) are among the most common bacterial infections affecting people of all ages. Worldwide, UTIs affect around 150 million people every year. The most common microbes responsible for UTI are Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus etc. Resistance of urinary tract pathogens to commonly prescribed antibiotics has increased worldwide. Asian countries present the highest rates of drug resistance. Increased emergence of bacterial resistance and the limited options of novel antimicrobial agents have necessitated the reintroduction of some old antimicrobial agents. Fosfomycin trometamol is an oral, uro-selective, broad-spectrum antibiotic showing excellent bactericidal activity against a range of Gram-positive as well as Gram-negative organisms, including drug-resistant pathogens. Oral Fosfomycin is approved in Europe, USA as well as in India for the treatment of uncomplicated urinary tract infections in women. The current American (IDSA), European (ESCMID) and other International guidelines recommend Fosfomycin as one of the first-line agents for the treatment of uncomplicated UTIs. Fosfomycin has the pharmacokinetic aspects that favour its use for the treatment of UTIs. Research studies have shown that most uropathogens exhibit low resistance and are highly susceptible to Fosfomycin. Indian studies have consistently showed that 90 to 100% of uropathogens exhibit susceptibility to Fosfomycin. Clinical evidence also shows Fosfomycin to be highly effective in the prophylaxis of recurrent UTIs. In the current era of alarmingly high antibiotic resistance rates, a single-dose Fosfomycin, may play an important role in the treatment of uncomplicated urinary tract infection, particularly in patients with poor drug compliance.