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Chapter 37 : Fosfomycin and Derivatives

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Abstract:

This chapter provides an overview about fosfomycin and derivatives. Fosfomycin belongs to the class of phosphonic antibiotics possessing a broad spectrum and exhibiting bactericidal activity against bacteria that fall within that spectrum. Two studies are reported in the literature; in one a broth medium was used to determine the MICs, while in the other the MICs in Mueller-Hinton agar were investigated. The in vitro activity of fosfomycin trometamol was better than that of pipemidic acid against and and better than that of amoxicillin against and . Fosfomycin inhibits bacterial cell wall biosynthesis by acting on the initial stage in the synthesis of peptidoglycan precursors. N-Acetylglucosamine-3-O-enolpyruvyl transferase is essential for any bacterium possessing muramic acid in its cell wall structure, which accounts for the broad spectrum of antibacterial activity of fosfomycin since numerous gram-positive or -negative species possess muramic acid that constitutes cell wall peptidoglycan. For fosmidomycin, the principal intracellular target has not been identified. It would appear that fosfomycin and fosmidomycin have different targets in and/or that, in the absence of the hexose phosphate transport route, these two products are transported into the bacterial cell by different mechanisms. The results of studies of combinations of fosfomycin with other antibiotics, particularly β-lactams, are described in this chapter. Due to its good diffusion into bone, fosfomycin has been recommended in the treatment of staphylococcal bone and joint infections or those due to .

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37

Key Concept Ranking

Cell Wall Biosynthesis
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Urinary Tract Infections
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Antibacterial Agents
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Bacterial Cell Wall
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Figures

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Figure 1

Synthesis of fosfomycin trometamol

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
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Image of Figure 2
Figure 2

Chemical formulae of fosfomycin, fosmidomycin, tromethamine, and fosfomycin trometamol

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
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Figure 3

Proposed chemical reaction during the enzymatic inactivation of fosfomycin in the presence of glutathione

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
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References

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Tables

Generic image for table
Table 1

In vitro activity of fosfomycin in Mueller-Hinton medium supplemented with G-6-P at 50 μg/ml

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
Generic image for table
Table 2

In vitro activity of fosfomycin trometamol in nutrient broth and in the presence of urine comparison with fosfomycin calcium, pipemidic acid, and co-trimoxazole

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
Generic image for table
Table 3

Susceptibility of and other agents of urinary tract infections to fosfomycin trometamol compared with four other antibiotics (urinary)

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
Generic image for table
Table 4

Pharmacokinetic parameters of fosfomycin, fosmidomycin, fosfomycin trometamol, and fosfomycin calcium

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
Generic image for table
Table 5

Concentrations of fosfomycin in plasma in patients with renal insufficiency

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37
Generic image for table
Table 6

Tissue distribution of fosfomycin

Citation: Bergogne-BéRézin E. 2005. Fosfomycin and Derivatives, p 972-982. In Bryskier, M.D. A (ed), Antimicrobial Agents. ASM Press, Washington, DC. doi: 10.1128/9781555815929.ch37

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