Antimicrobials
Fosfomycin IV

Fosfomycin IV

Restricted

Low
Low

Dosing

General Information

  • Urinary Tract Infection, especially involving ESBL producing organisms
  • Offlabel - Prostatitis

Serum electrolytes; renal function, liver function

Sodium content (320 mg per gram of IV fosfomycin) should be considered in patients requiring sodium restriction. Use with caution in patients with cardiac insufficiency, hypertension, hyperaldosteronism, hypernatremia, pulmonary edema, or hepatic cirrhosis. 

A high sodium load may also result in decreased serum potassium level.

Assess electrolytes (sodium, potassium, and phosphate) and fluid balance regularly, in particular for patients receiving digoxin or when using the high-dose regimen (>16 g/day in adults 

There are limited safety data for doses >16 g/day.

  • GI upset, especially diarrhea

  • Headache

  • Eosinophilia, neutropenia

  • Hypokalemia

  • BCG Vaccine: Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization). Monitor therapy.
  • Cholera Vaccine: Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Avoid combination
  • Estriol: Antibiotics may diminish the therapeutic effect of Estriol. Monitor therapy.

Antimicrobial class: Phosphonic acid derivative

Pregnancy category: B

Breastfeeding: Compatible

Fosfomycin produces low levels in milk and is unlikely to be absorbed well by the infant 

Average serum half life: 6 hours

Urine penetration: Therapeutic