Composition
Cap 500 mg: Fosfomycin 500 mg. Inj1 gm IM/IV: Fosfomycin 1 gm. Susp 250 mg/500 mg: Per 5 ml: Fosfomycin 250 mg/500 mg. Powder: Fosfomycin trometamol 3 gm.
Indications & Dosage
Acute uncomplicated lower urinary-tract infections: ORAL SACHET: Adult: 3 g single-dose 1 sachet, mix with 3-4 oz of water. Prophylaxis of urinary-tract infections in transurethral surgical procedures: ORAL SACHET: Adult: 3 g single-dose 1 sachet, mix with 3-4 oz of water, to be given 3 hours before surgery. Dose maybe repeated once, 24 hours after surgery. Osteomyelitis, Hospital-acquired lower respiratory-tract infections when first-line treatments are inappropriate or ineffective: ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly. BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly. BY IV INF: Adult: 12-24 g daily in 2-3 divided doses (max. per dose 8 g), use the high-dose regimen in severe infection suspected or known to be caused by less sensitive organisms. Children: half the adult dose; see literature. Complicated urinary-tract infections when first-line treatment ineffective or inappropriate: ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly. BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly. BY IV INF: Adult: 12-16 g daily in 2-3 divided doses (max. per dose 8 g). Children: half the adult dose; see literature. Bacterial meningitis when first-line treatment ineffective or inappropriate: ORAL: Adults: 500 mg 6 hourly. Children: 250 mg 6 hourly. BY IM INJ: Adult: 1 g 8 hourly; Children: 500 mg 8 hourly. BY IV INF: Adult: 16-24 g daily in 3-4 divided doses (max. per dose 8 g), use the high-dose regimen in severe infection suspected or known to be caused by less sensitive organisms. Children: half the adult dose; see literature.
Administration
The-duration of infusion should be at least 15 mins for 2 gm, at least 30 mins for 4 gm and at least 60 mins for 8 gm. Use only clear solutions. As damaging effects can result from inadvertent intra-arterial; administration of products not specifically recommended for intra-arterial therapy. The duration of treatment depends on the individual response of the pathogens and the patients clinical outcome.
Precautions
Cardiac insufficiency, elderly (high doses), hyperaldosteronism, hypernatraemia, hypertension, pulmonary oedema, renal impairment. With intravenous use, monitor electrolytes and fluid balance
Interactions
Antacids, metoclopramide and drugs altering GI motility.
Pregnancy
Use only if potential benefit outweighs risk.
Lactation
Contraindicated
Side Effects
GI disturbances, diarrhoea, nausea, rash, vomiting, abdominal pain, antibiotic-associated colitis, dizziness, headache, decreased appetite, dyspnea, fatigue, hypernatraemia, hypokalaemia, taste disturbances, vertigo. Rare: Aplastic anaemia, blood disorders, eosinophilia, bronchospasm, confusion, hepatitis, jaundice, tachycardia