Overview on fosfomycin and its current and future clinical significance

Fosfomycin is an old antibiotic with a unique chemical structure and with broad-spectrum activity against numerous bacterial pathogens, both Gram-positive and Gramnegative, including resistant and multi-resistant strains. This antibiotic was accepted into clinical practice in the early 1970s. Its use, however, has been limited for several years for treating mainly lower uncomplicated urinary tract infections (in the form of fosfomycin trometamol taken orally). Nowadays, many clinicians and scientists are looking at this antibacterial drug for its employment in the treatment of severe infections caused by multi-resistant bacteria. Fosfomycin as an intravenous formulation (fosfomycin disodium) achieves clinically relevant concentrations in the serum and the cerebrospinal fluid, in kidney, bladder wall, prostate, lungs, bone and heart valves tissues, as well as in inflamed tissues and abscess fluid. The available clinical studies confirmed the efficacy of intravenous fosfomycin for the management of severe infections caused by multiresistant pathogens.