Fosfomycin, an Antibacterial Agent for Urinary Tract Infections
Abstract
Canadian, American, and European guidelines and authorities recommend fosfomycin for managing acute uncomplicated cystitis.Fosfomycin is the main treatment option for multidrug-resistant (MDR) Gram-negative bacterial infections.Fosfomycin (C 3 H 7 O 4 P) is a member of the epoxide family and a derivative of phosphonic acid, with a molecular weight of 138 Da.Fosfomycin is an antibacterial drug that acts against both Gram-positive and -negative bacteria and is structurally unrelated to any other antibiotic class currently in use.Fosfomycin was developed in the late 1960s; however, fosfomycin use has experienced a resurgence owing to its ability to effectively combat various extensively drug-resistant (XDR) and MDR diseases, which is due to its distinct mode of action and wide range of activity.Enterobacteriaceae-related disease requires treatment with combination therapy owing to Enterobacteriaceae acquiring various antibiotic resistance genes through plasmids and mobile elements.Additionally, the emergence of fosfomycin-resistance genes in isolates originating from humans, animals, food, and the environment has raised concerns about the potential for the spread of these bacteria, particularly Salmonella and Escherichia coli, at the interfaces among humans, animals, and the environment.Many in vitro studies have focused on combining fosfomycin and carbapenems; however, additional pharmacokinetic, pharmacodynamic, and clinical studies are required to maximize the use of…
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