2. Fosfomycin (PO)
Bactericidal agent that is excreted into the urine and inhibits cell wall synthesis by interfering with peptidoglycan synthesis.
Spectrum: Broad spectrum vs Gram positive including MRSA, VRE; Gram negative including Pseudomonas and some ESBL’s .
Used for: Uncomplicated urinary tract infections in women, especially in those with history of resistant bugs. Given as a one-time mega-dose of 3 g (excreted into urine and achieves high levels there for several days. Sometimes used for complicated UTI’s in males with resistant pathogens (3 g PO q3 days x several doses), although this is an off-label use.