Fosfomycin

Mode of Action:
The bactericidal action of fosfomycin is due to its inactivation of the enzyme enolpyruvyl transferase, thereby irreversibly blocking the condensation of uridine diphosphate-N-acetylglucosamine with p-enolpyruvate, one of the first steps in bacterial cell wall synthesis. It also reduces adherence of bacteria to uroepithelial cells.

There is generally no cross-resistance between fosfomycin and other classes of antibacterial agents such as beta-lactams and aminoglycosides.

Drug Label Information | Brands:

Brands
Focin®, Tabros

INDICATIONS:

Fosfomycin is indicated only for the treatment of uncomplicated urinary tract infections (acute cystitis) in women due to susceptible strains of Escherichia coli and Enterococcus faecalis.Fosfomycin is not indicated for the treatment of pyelonephritis or perinephric abscess.

If persistence or reappearance of bacteriuria occurs after treatment with Fosfomycin, other therapeutic agents should be selected.

CONTRAINDICATIONS:

Fosfomycin is contraindicated in patients with known hypersensitivity to the drug.

ADVERSE DRUG REACTIONS:

angioedema, aplastic anemia, asthma (exacerbation), cholestatic jaundice, hepatic necrosis, and toxic megacolon.
anaphylaxis and hearing loss.

DRUG INTERACTIONS:

Metoclopramide: When coadministered with Fosfomycin, metoclopramide, a drug which increases gastrointestinal motility, lowers the serum concentration and urinary excretion of fosfomycin. Other drugs that increase gastrointestinal motility may produce similar effects.

Cimetidine: Cimetidine does not affect the pharmacokinetics of fosfomycin when coadministered with Fosfomycin.