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The problem of significantly reduced drug use concerns particularly the infections caused by multi-resistant pathogens, especially Gram-negative bacteria. In this regard, interest is increasing in the known for nearly 50 years, but now frequently forgotten antibiotic – fosfomycin. Fosfomycin possesses high effectiveness for multidrug-resistant bacteria, comprising of extended-spectrum β-lactamases (ESBL), Klebsiella pneumoniae carbapenemases (KPC); commonly, the pandrug-resistant (PDR) and the extensively drug-resistant (XDR) strains, especially from Enterobacteriaceae family. Because of facilitated distribution into inflamed tissues and a very broad range of in vitro bactericidal activity, fosfomycin may have various applications in the treatment of many kinds of bacterial infections, including acute uncomplicated infections of the urinary bladder or complicated urinary tract infections, urinary tract sepsis, pyelonephritis, cystitis, prostatitis and chronic lung infections in patients with cystic fibrosis, the great majority caused by multi-resistant Gram-negative bacteria, and in the therapy eradicating multidrug-resistant Helicobacter pylori. Fosfomycin may limit the toxicity of other antibiotics and play a protective role in the process of bacterial resistance development during the therapy. Combinations of different antimicrobials enable the use of forgotten antibiotics in commonly occurring infections, although they are still completely incurable.

Fosfomycin as an alternative therapeutic option for treatment of infections caused by multi-resistant Gram-negative bacteria