Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Fosfomycin

C. diff Risk

Low

Oral Bioavailability

Low (20 to 40%)

Approximate Cost

$26.10/dose

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Renal

Intermittent Dialysis
Dose post-hemodialysis

Adult

Approved at Eastern Health for Uncomplicated UTI only

Female, Uncomplicated UTI
3g PO once

Complicated or male UTI (OFF LABEL USE)
3g PO q2-3days x 3 doses

General Information

Acceptable Uses

Acceptable Uses

Treatment of uncomplicated cystitis

Unacceptable Uses

Unacceptable Uses

  • Pyelonephritis

  • Bacteremia

  • Urosepsis

  • Perinephric abscess

Common Usage

Common Usage

Uncomplicated Urinary Tract Infection, especially involving ESBL producing organisms

Offlabel - Prostatitis, complicated UTI

Adverse Effects

Adverse Effects

  •  GI upset, especially diarrhea

  •  Headache

  •  Eosinophilia, neutropenia

  •  Hypokalemia

Major Interactions

Major Interactions

No significant interactions

Coverage

NLPDP Status

SPECIAL AUTHORIZATION REQUIRED

Additional Information

Additional Information

For cystitis only. Do not use in pyelonephritis or urosepsis/bacteremia

EH Prescribing Restrictions
None

NLPDP Status
Special Authorization required
More Information

Supplied as 3g powder in sachet; dissolve in 3-4 oz fluid

Can be given PO or via NG tube

Bioavailability < 40% however achieves high concentrations for prolonged period in urine

Pharmacology

Pharmacology

Antimicrobial class: Phosphonic acid derivative

Pregnancy category: B

Average serum half life: 6 hours

Urine penetration: Therapeutic