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Fosfomycin Tromethamine: A Urinary Antibiotic
Abhijit A Trailokya1, Mangesh Tiwaskar2
1Head, Department of Medical Affairs, Indoco Remedies Limited, Mumbai, Maharashtra, India, Corresponding Author, Orcid: https://orcid.org/0009-0002-7657-8119.
The Journal of the Association of Physicians of India
|October 16, 2025
Summary
Fosfomycin tromethamine offers a safe and effective single-dose treatment for uncomplicated urinary tract infections (UTIs). This broad-spectrum antibiotic inhibits bacterial cell wall synthesis, showing high cure rates and patient compliance.
Area of Science:
- Pharmacology and Infectious Diseases
Background:
- Urinary tract infections (UTIs) are highly prevalent, affecting millions globally each year, with women disproportionately impacted by recurrent episodes.
- Fosfomycin tromethamine, discovered in 1969, is a key antibiotic for managing uncomplicated UTIs.
Purpose of the Study:
- To review the pharmacological profile and clinical efficacy of fosfomycin tromethamine for treating uncomplicated urinary tract infections.
Main Methods:
- Review of clinical trials and observational studies on fosfomycin tromethamine.
- Analysis of its mechanism of action, pharmacokinetics, and safety profile.
Main Results:
- Fosfomycin inhibits bacterial cell wall synthesis by targeting the MurA enzyme, effective against gram-negative and gram-positive pathogens, including multidrug-resistant strains.
- A single 3 gm oral dose achieves high urinary concentrations (1053–4415 mg/L) for 24–48 hours, inhibiting most uropathogens.
- Clinical studies demonstrate high cure rates and excellent patient compliance due to its single-dose regimen and minimal side effects.
Conclusions:
- Fosfomycin tromethamine is a well-established, effective, and safe antibiotic for uncomplicated UTIs, supported by clinical guidelines.
- Its unique pharmacokinetic properties and single-dose administration make it a valuable option for patient convenience and treatment success.
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