title: Fosfomycin.
abstract: The treatment of bacterial infections suffers from two major problems: spread of multidrug-resistant (MDR) or extensively drug-resistant (XDR) pathogens and lack of development of new antibiotics active against such MDR and XDR bacteria. As a result, physicians have turned to older antibiotics, such as polymyxins, tetracyclines, and aminoglycosides. Lately, due to development of resistance to these agents, fosfomycin has gained attention, as it has remained active against both Gram-positive and Gram-negative MDR and XDR bacteria. New data of higher quality have become available, and several issues were clarified further. In this review, we summarize the available fosfomycin data regarding pharmacokinetic and pharmacodynamic properties, the in vitro activity against susceptible and antibiotic-resistant bacteria, mechanisms of resistance and development of resistance during treatment, synergy and antagonism with other antibiotics, clinical effectiveness, and adverse events. Issues that need to be studied further are also discussed.
authors.affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece Department of Internal Medicine-Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece Department of Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA m.falagas@aibs.gr.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
authors.affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece.
authors.forename: Evridiki K
authors.initials: EK
authors.lastname: Vouloumanou
authors.affiliation: Department of Internal Medicine, University of Crete School of Medicine, Heraklion, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Samonis
authors.affiliation: Alfa Institute of Biomedical Sciences, Athens, Greece Department of Internal Medicine-Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece.
authors.forename: Konstantinos Z
authors.initials: KZ
authors.lastname: Vardakas
mesh_terms: D000900:Anti-Bacterial Agents / Q000737:chemistry / Q000494:pharmacology*; D004336:Drug Antagonism; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects; D004357:Drug Synergism; D005578:Fosfomycin / Q000737:chemistry / Q000494:pharmacology*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents; D005578:Fosfomycin