Fosfomycin

Phosphomycin is a broad-spectrum antibiotic of natural origin obtained from cultures of Streptomyces fradiae .

Fosfomycin - Chemical structure

Indications

For what it uses

Phosphomycin is used in the treatment of infections caused by bacteria sensitive to phosphomycin itself.

More in detail, the use of fosfomycin is indicated for the treatment of acute uncomplicated infections of the lower urinary tract.

Moreover, the drug can be used in the prevention of urinary infections in surgical operations and in transurethral diagnostic maneuvers.

Warnings

If any type of allergic reaction occurs, treatment with fosfomycin should be stopped immediately and a doctor should be contacted immediately.

In case of severe, persistent and / or blood diarrhea, it is necessary to inform the doctor immediately, even if the diarrhea occurs weeks after the end of the antibiotic treatment.

Treatment with fosfomycin may alter the results of blood tests performed to determine clotting time.

Phosphomycin can cause side effects that can affect the ability to drive and / or operate machinery. Therefore, caution should be used.

Food may decrease the absorption of fosfomycin. Therefore, the drug should be taken on an empty stomach.

Interactions

Concomitant administration of phosphomycin and metoclopramide (an anti-emetic, ie anti-viral drug) may reduce the absorption of fosfomycin itself.

Concomitant administration of fosfomycin and antacid drugs or calcium salts may cause a reduction in plasma and urinary concentration of fosfomycin.

Phosphomycin may increase the activity of vitamin K antagonists .

In any case, you must inform your doctor if you are taking - or have recently been taken - drugs of any kind, including non-prescription medicines and herbal and / or homeopathic products.

Side effects

Phosphomycin can cause various side effects, although not all patients experience them. The type of side effects and the intensity with which they occur depend on the different sensitivity that each person has towards the drug itself.

Listed below are the main adverse effects that may occur during phosphomycin therapy.

Gastrointestinal disorders

Treatment with fosfomycin may cause nausea, vomiting, abdominal pain, dyspepsia, diarrhea and antibiotic colitis.

Allergic reactions

Phosphomycin, like any other drug, can cause allergic reactions in sensitive individuals. These reactions can occur in the form of angioedema and anaphylactic shock.

Hepatobiliary disorders

The phosphomycin-based therapy can cause liver problems accompanied by a temporary increase in liver transaminases.

Blood and lymphatic system disorders

Treatment with fosfomycin may cause a slight increase in the blood counts of leukocytes, eosinophils and platelets. Furthermore, the drug can promote the onset of aplastic anemia.

Lung and respiratory tract disorders

Phosphomycin therapy may cause dyspnea, bronchospasm and asthma.

Skin and subcutaneous tissue disorders

Treatment with fosfomycin can cause rashes, hives and itching.

Cardiovascular disorders

The phosphomycin-based therapy can promote the onset of tachycardia, hypotension and phlebitis.

Nervous system disorders

Headache and dizziness may occur during treatment with fosfomycin.

Other side effects

Other side effects that may occur during treatment with fosfomycin are:

Loss of appetite;
Vision disorders;
Superinfections with resistant bacteria or fungi;
Vulvovaginitis.

Overdose

After taking an overdose of fosfomycin, symptoms such as:

Loss of balance;
Hearing problems;
Decreased taste perception;
Perception of a metallic taste.

In the event of an overdose of fosfomycin, liquids should be administered in order to facilitate the elimination of excess drug via urine.

In any case, if you suspect overdosing, you must contact your doctor immediately.

Action mechanism

Phosphomycin is an antibiotic with a bactericidal action, ie it is able to kill bacterial cells.

Phosphomycin exerts its antimicrobial action by interfering with the synthesis of peptidoglycan, the fundamental component of the bacterial cell wall.

More precisely, fosfomycin inhibits the action of a crucial enzyme in the formation of the aforementioned peptidoglycan: enolpyruvate transferase.

Mode of Use - Posology

A fosfomycin is available for oral administration in the form of granules for oral suspension.

The granules must be dissolved in water and must be taken on an empty stomach, at least two or three hours after meals. Generally, it is recommended to take the antibiotic before sleeping at night and after emptying the bladder.

The duration of the treatment is established by the doctor and it is necessary to strictly follow his instructions.

Below are some indications on the doses of fosfomycin usually used in therapy.

Adults and adolescents from 12 to 18 years of age

In this category of patients, the dose of phosphomycin usually used is 3 g of drug, to be taken in a single daily dose.

Children from 6 to 12 years of age

In children between the ages of 6 and 12, the dose of phosphomycin usually administered is 2 g of drug, to be taken in a single dose.

Elderly patients and bedridden patients

In this category of patients, it may be necessary to administer two doses of 3 g of phosphomycin, to be taken 24 hours apart.

Prevention of urinary infections in surgical operations and transurethral diagnostic maneuvers

In these cases, 3 g of phosphomycin is expected to be administered three hours before surgery. 24 hours after the first administration, a new dose of 3g phosphomycin should be administered.

Pregnancy and breastfeeding

The use of fosfomycin by pregnant women and by breast-feeding mothers should be done only in cases of absolute necessity and only under the strict supervision of the doctor.

In any case, pregnant women and breastfeeding mothers - before taking any type of medication - should always seek medical advice.