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Fosfomycin.

Matthew E Falagas1, Evridiki K Vouloumanou2, George Samonis3

  • 1Alfa Institute of Biomedical Sciences, Athens, Greece Department of Internal Medicine-Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA m.falagas@aibs.gr.

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Fosfomycin shows sustained activity against multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacteria, offering a viable option when other antibiotics fail. This review details its properties, effectiveness, and resistance mechanisms for treating challenging infections.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • The rise of multidrug-resistant (MDR) and extensively drug-resistant (XDR) bacterial pathogens presents a critical global health challenge.
  • Limited development of novel antibiotics necessitates the re-evaluation and optimized use of existing agents, including older drugs like fosfomycin.

Purpose of the Study:

  • To provide a comprehensive review of fosfomycin's current data, focusing on its utility against resistant bacteria.
  • To analyze fosfomycin's pharmacokinetic/pharmacodynamic properties, in vitro activity, resistance mechanisms, clinical efficacy, and safety profile.

Main Methods:

  • Systematic review of recent high-quality data on fosfomycin.
  • Analysis of in vitro susceptibility testing against susceptible and resistant bacterial strains.
  • Evaluation of clinical studies assessing fosfomycin's effectiveness and adverse events.

Main Results:

  • Fosfomycin maintains broad-spectrum activity against Gram-positive and Gram-negative MDR/XDR bacteria.
  • Recent data have clarified fosfomycin's pharmacokinetic/pharmacodynamic properties and resistance patterns.
  • Information on synergy/antagonism with other antibiotics and clinical outcomes has been updated.

Conclusions:

  • Fosfomycin remains a valuable therapeutic option for infections caused by MDR and XDR bacteria.
  • Further research is needed to fully elucidate optimal dosing strategies and address emerging resistance concerns.
  • Understanding fosfomycin's profile is crucial for managing challenging bacterial infections effectively.