Abstract

FOSFOMYCIN: AN ASSESSMENT OF ITS POTENTIAL FOR USE IN THE TREATMENT OF MDR- ESCHERICHIA COLI IN URINARY TRACT INFECTIONS

Fathimath Kamila Thasneem*, Ashitha Ephrem and A. R. Shabaraya

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Abstract

Antimicrobial resistance is increasing worldwide making it difficult to choose an appropriate therapy for the infections caused by the resistant pathogens. Fosfomycin, an antibiotic that was discovered about decades ago, has drawn renewed interest as an active agent against multi-drug resistant (MDR) organisms especially in the treatment of Urinary Tract Infections (UTIs) because of its unique mechanism of action and broad spectrum of activity. Available as oral and intravenous formulation, it has minimal interactions with other medications and a favourable safety profile and can be equally administered in pregnant women, elderly and those with renal and hepatic impairment. Commonly used as a single dose therapy or in combination with other antibacterial agents, fosfomycin has high treatment efficacy in UTIs caused by MDR Escherichia coli (E.Coli). Extended courses of fosfomycin can be considered in patients with poor/ no response to treatment and both the treatment regimens have been shown to be generally well tolerated. Dosage adjustment is recommended in patients with creatinine clearance less than 50ml/min/1.73m2. The unique mechanism of action of fosfomycin limits the appearance of cross resistance and allows it to remain effective against the MDR pathogens. In addition to its excellent bactericidal activity, fosfomycin also has the potential to reduce toxicity associated with other antibacterial agents. In this review, we have discussed the potential for using fosfomycin to treat MDR E.Coli infections in UTI.

Keywords: Fosfomycin, Urinary Tract Infections, Multi drug Resistant Organisms, E.Coli infections.