Fosfomycin: the characteristics, activity, and use in critical care

Area of Science:

• Pharmacology
• Infectious Diseases
• Microbiology

Background:

• Fosfomycin is a phosphonic acid derivative and an epoxide antibiotic.
• It possesses a broad spectrum of activity against Gram-positive and Gram-negative bacteria.
• Fosfomycin has the lowest molecular weight among existing antibacterial agents.

Purpose of the Study:

• To highlight the re-emerging role of fosfomycin in treating severe infections.
• To discuss its utility in intensive care unit (ICU) patients with soft tissue infections (STIs).
• To explore its application against multidrug-resistant Enterobacteriaceae and other serious systemic infections.

Main Methods:

• Review of existing literature on fosfomycin's properties and clinical applications.
• Analysis of fosfomycin's pharmacokinetic profile, including its distribution and lack of need for dose adjustment in hepatic impairment.
• Examination of its use in various serious infections like osteomyelitis, respiratory tract infections, UTIs, meningitis, and bacteremia.

Main Results:

• Fosfomycin demonstrates bactericidal activity against a wide range of bacteria.
• Intravenous administration achieves sufficient drug concentrations in various body regions.
• It is a valuable option for treating severe infections, including those caused by multidrug-resistant pathogens.

Conclusions:

• Fosfomycin is a versatile antibiotic with renewed clinical interest, especially for severe and multidrug-resistant infections.
• Its favorable pharmacokinetic profile makes it suitable for intensive care settings.
• Fosfomycin represents an important therapeutic option for challenging bacterial infections.