Single-dose fosfomycin tromethamine: Evaluation in the treatment of uncomplicated lower urinary tract infection

Escherichia coli accounts for 80% to 90% of uncomplicated lower urinary tract infections (UTls) and Staphylococcus saprophyticus, Enterococcus faecalis, and Klebsiella pneumoniae are responsible for most other infections. Pathologically, lower UTI is a superficial mucosal infection of the bladder that occurs because pathogenic organisms adhere to the urothelial lining. Successful treatment, therefore, is predicated on quickly achieving an inhibitory concentration of antibacterial agent in the urine. An ideal agent for treating UTI should achieve and maintain bactericidal levels quickly above the minimum inhibitory concentration (MIC90). Fosfomycin tromethamine has excellent activity against the aerobic gram-negative bacilli (E coli) usually responsible for uncomplicated UTl. Orally administered fosfomycin is well tolerated and excreted in high concentrations as free drug in the urine.