Fosfomycin: Pharmacological, Clinical and Future Perspectives

Area of Science:

• Pharmacology
• Microbiology
• Infectious Diseases

Background:

• Fosfomycin is a broad-spectrum antibiotic with bactericidal activity.
• It inhibits bacterial cell wall synthesis, showing potential against multidrug-resistant Gram-negative bacteria.
• Fosfomycin exhibits synergistic effects with other antibiotics, potentially reducing toxicity.

Purpose of the Study:

• To review the pharmacological properties of fosfomycin.
• To explore its potential applications in treating infections caused by multidrug-resistant bacteria.
• To highlight the need for further research regarding its efficacy and resistance mechanisms.

Main Methods:

• Literature review of existing pharmacological data.
• Analysis of pharmacokinetic and pharmacodynamic (PK/PD) simulations.
• Discussion of clinical evidence and potential therapeutic strategies.

Main Results:

• Fosfomycin demonstrates broad-spectrum activity and good tissue penetration, suitable for various infection sites.
• Oral bioavailability is limited, restricting current approved use to single-dose urinary tract infections.
• PK/PD simulations suggest potential for multiple-dose regimens against resistant bacteria.

Conclusions:

• Fosfomycin is a promising antibiotic, particularly in combination therapy for multidrug-resistant infections.
• Limited understanding of resistance mechanisms and optimal dosing necessitates further investigation.
• Fosfomycin monotherapy is not recommended due to potential for resistance development.