Fosfomycin and nitrofurantoin: classic antibiotics and perspectives

Area of Science:

• Infectious Diseases
• Pharmacology
• Microbiology

Background:

• Antimicrobial resistance (AMR) is a growing global health threat due to widespread antibiotic use.
• Declining new drug development and economic factors limit treatment options for infections.
• Older antibiotics, like nitrofurantoin and fosfomycin, require updated evaluation for current efficacy.

Purpose of the Study:

• To review the contemporary use of nitrofurantoin and fosfomycin for urinary tract infection (UTI) control.
• To explore innovative strategies, including combination therapies, for enhancing antibiotic effectiveness against UTI pathogens.
• To assess prospects for mitigating bacterial resistance to these classic antibiotics.

Main Methods:

• Systematic literature review of studies on nitrofurantoin and fosfomycin for UTIs.
• Analysis of historical and recent clinical data regarding antibiotic efficacy and resistance patterns.
• Exploration of emerging combination therapies and resistance-mitigation approaches.

Main Results:

• Nitrofurantoin and fosfomycin remain relevant for treating specific UTIs, but their use is often based on outdated evidence.
• Emerging combination regimens show potential for broadening antimicrobial spectra and overcoming resistance.
• Further research is crucial to optimize the use of these antibiotics and combat resistance.

Conclusions:

• Re-evaluation of established antibiotics like nitrofurantoin and fosfomycin is critical in the face of AMR.
• Novel therapeutic strategies are needed to enhance the efficacy of these drugs and preserve their utility.
• Systematic evaluation and updated clinical guidelines are essential for effective UTI management and AMR containment.