Fosfomycin for UTIs

Fosfomycin trometamol is a broad spectrum antibiotic recently marketed in the UK for the treatment of acute uncomplicated lower urinary tract infections (UTIs) in adults^1,2 and in adult and adolescent females.³ It is also indicated for prophylaxis in diagnostic and surgical transurethral procedures.^1-3 Fosfomycin was discovered in 1969 and the reference drug was first marketed as Monuril in France in 1986.^3,4 Although Monuril had UK marketing authorisation, it was never distributed in the UK. However, national guidance included the option of using unlicensed imported fosfomycin.^3,5,6 Branded and generic versions of fosfomycin are now available in the UK,^1-3,7 and here we review the evidence for their use in the treatment of UTIs.