Fosfomycin

Introduction: Fosfomycin belongs to a group of medicines known as antibiotics. It works by killing bacteria, which can cause infections. This medicine is used to treat or prevent infections of the urinary tract.

How it works: Fosfomycin is a phosphoenolpyruvate (PEP) analogue that irreversibly inhibits enolpyruvate transferase (MurA), which prevents peptidoglycan biosynthesis, thus inhibiting bacterial cell wall biogenesis and showing bactericidal effects.

Important Information: It should be taken on an empty stomach, preferably before bedtime, after emptying the bladder. Complete a full course of this antibiotic as prescribed. If your condition does not improve after two to three days, consult your doctor.

• Uncomplicated urinary tract infections (acute cystitis): in women caused by susceptible strains of Escherichia coli and Enterococcus faecalis.

Intracellular antibiotic

Phosphonic acid derivative

Fosfomycin is a phosphonic acid derivative. It is a synthetic, broad spectrum, bactericidal antibiotic for oral administration. The bactericidal action of Fosfomycin is due to its inactivation of the enzyme enolpyruvyl transferase, thereby irreversibly blocking the condensation of uridine diphosphate N-acetylglucosamine with p-enolpyruvate, one of the first steps in bacterial cell wall synthesis.

Fosfomycin inhibits MurA enzyme to prevent bacterial cell wall formation, resulting in bacterial death.

Adult Dose (Acute Cystitis):

• Women (18+): 1 sachet (3 g) PO once
• Men (18+): 1 sachet (3 g) every 2-3 days for 3 doses
• Prostatitis: 3 g PO every 3 days for 21 days

Renal Impairment: No dosage adjustment needed.

Children: Should not be used in children.

* Use as directed by the registered physician

Oral sachet. Take on an empty stomach (preferably at bedtime, after emptying the bladder). Pour the contents of one sachet into a glass of water, stir to dissolve completely and drink immediately.

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and follow your regular schedule.

Common Side Effects (>1%):

• Diarrhea - 10.4%
• Headache - 10.3%
• Vaginitis - 7.6%
• Nausea - 5.2%
• Rhinitis - 4.5%
• Back pain - 3.0%
• Dysmenorrhea - 2.6%
• Pharyngitis - 2.5%
• Dizziness - 2.3%
• Abdominal pain - 2.2%
• Dyspepsia - 1.8%
• Asthenia - 1.7%
• Rash - 1.4%

Precautions:

• Do not use more than one single dose to treat a single episode of acute cystitis (repeated doses do not improve efficacy, increase adverse events).
• Avoid alcohol and caffeinated drinks, and drink plenty of water.
• Diarrhea is a common side effect - inform your doctor if it does not get better or if you see blood in stools.
• Fosfomycin may cause dizziness or sleepiness - don't drive or do anything requiring concentration.

Contraindications:

• Hypersensitivity to fosfomycin
• Severe renal insufficiency
• Patients undergoing haemodialysis

Drug Interactions:

• Additive or synergistic effect with β-lactam antibiotics (penicillin, ampicillin, cefazolin, carbapenems) and anti-staphylococcal agents.
• Metoclopramide (drugs that increase GI motility) reduces serum levels.

Food Interactions:

• Consuming alcohol with Fosfomycin does not cause any harmful side effects.

Use in Pregnancy: Generally considered safe during pregnancy. Animal studies have shown low or no adverse effects to the developing baby.

Use in Lactation: Probably safe during breastfeeding. Limited data suggests the drug does not represent any significant risk to the baby.

Pediatric Use: Should not be used in children.

Geriatric Use: No specific dosage adjustment is necessary for elderly patients.

Renal Impairment: Use with caution in kidney disease. Not recommended in severe kidney disease.

Hepatic Impairment: Limited information available. Please consult your doctor.

Overdose: Overdose may cause gastrointestinal disturbances. Gastric lavage and supportive care.

Storage: Store below 25°C, in a dry place, protected from light. Keep out of reach of children.

Fosfomycin Sachet