Fosfomycin (Monurol) Antibiotic Quiz

Study Notes

Fosfomycin (Monurol): A Unique Antibiotic for Bacterial Infections

Fosfomycin, marketed as Monurol, is a unique antibiotic that belongs to the phosphonic acid class. Discovered in the 1960s, it has garnered renewed attention due to its utility in treating multidrug-resistant bacterial infections.

Mechanism of Action

Fosfomycin works by targeting bacterial cell walls, specifically the enzyme MurA, which is responsible for synthesizing the peptidoglycan component. By inhibiting MurA, fosfomycin prevents the cross-linking of peptidoglycan chains, leading to cell wall weakness and eventually cell lysis.

Spectrum of Activity

Fosfomycin is particularly effective against gram-negative bacteria such as Escherichia coli and Klebsiella species, including multidrug-resistant strains. It is also active against some gram-positive bacteria, such as Staphylococcus aureus and Streptococcus species.

Administration

Fosfomycin is primarily administered orally for urinary tract infections (UTIs) and as a single intravenous dose for serious infections.

Compartment Specificity

Fosfomycin has unique properties that enable it to penetrate biofilms and effectively treat infections caused by bacteria embedded within these structures.

Resistance

Resistance to fosfomycin is uncommon, with spontaneous mutations occurring in 1-2% of E. coli and Klebsiella species. Bacterial resistance can also be acquired through horizontal gene transfer, but this is rare.

Side Effects

Fosfomycin is generally well-tolerated, with the most common side effects being gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Allergic reactions, although rare, can occur, and patients with a history of penicillin allergy may be more likely to experience side effects.

Use in Combination

Fosfomycin can be combined with other antibiotics to treat infections caused by multidrug-resistant bacteria. For example, fosfomycin has shown synergy with beta-lactams, such as amoxicillin.

As with all antibiotics, it is essential to use fosfomycin judiciously to minimize the development of resistance. Fosfomycin can be a valuable tool in treating infections caused by bacteria that are resistant to other antibiotics, but it should not be used indiscriminately.

Description

Test your knowledge about the unique antibiotic fosfomycin, marketed as Monurol, its mechanism of action, spectrum of activity, administration, resistance profile, side effects, and combination therapy. Learn how fosfomycin can be used to treat multidrug-resistant bacterial infections effectively.