Fosfomycin is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Fosfomycin (3-g sachet dissolved in cold water PO once) is a bactericidal oral antibiotic that kills bacteria by inhibiting an early step in cell wall synthesis. It has a spectrum of activity that includes most urinary tract pathogens, including P. aeruginosa, Enterobacter spp., and enterococci (including VRE), and some multidrug-resistant gram-negative bacteria.

  • It is most useful for treating uncomplicated UTIs in women with susceptible strains of E. coli or E. faecalis. It should not be used to treat pyelonephritis or systemic infections.

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