Fosfomycin for urinary tract infections guide
This guide applies only when fosfomycin is prescribed for acute, uncomplicated cystitis in women or female adolescents over 12 years of age.
Fosfomycin for urinary tract infections guide
This guide applies only when fosfomycin is prescribed for acute, uncomplicated cystitis in women or female adolescents over 12 years of age.
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- 2 min read
- PATHWAY
- Fosfomycin
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How to use
- Take the sachet as a single dose
Dissolve the 3 g sachet in a glass of water and drink it immediately. Take it on an empty stomach, preferably before bedtime after emptying your bladder.
- Use only for the selected infection
The single-dose regimen is for acute uncomplicated cystitis in the selected patient group. It is not the regimen for a kidney infection, a complicated UTI, or a UTI in a male patient.
Medicines and interactions to review. Metoclopramide and other medicines that speed intestinal transit can reduce fosfomycin exposure
Treatment pathway
See the full decision pathway
Protocol pathway
Confirm a localised lower UTI
Fever, chills, flank pain, vomiting, pregnancy, or systemic illness require another care pathway.
Use the selected prescription
The protocol prioritises fosfomycin 3 g once. Nitrofurantoin modified release 100 mg every 12 hours for 5 days is the alternative only when fosfomycin is unsuitable and nitrofurantoin is safe.
Review at 48 hours if not improving
Do not switch antibiotics automatically. A urine culture or in-person review may be needed.
Dose schedule
- Single-dose treatment
The authorised regimen is one 3 g dose. Contact a clinician promptly if symptoms do not begin to improve or if they worsen.
- Seek review for warning symptoms
Fever, chills, pain in the back or side, vomiting, or worsening symptoms need prompt clinical review because they may indicate an infection outside this guide's scope.
Side effects
Gastrointestinal effects
Diarrhoea, nausea, indigestion, and abdominal pain are most common. Usually mild and short-lived.
Other possible effects
Headache, dizziness, and vaginal itching. Allergic skin reactions are uncommon.
Do not use if
- You are allergic to fosfomycin
- You have fever, chills, flank pain, vomiting, or feel systemically unwell
- The infection is complicated, you are pregnant, or this guide's selected patient group does not apply
If any item may apply, do not use the medicine until a clinician has reviewed it.
When to contact your doctor
- Symptoms worsen or fail to improve, or you develop fever, chills, back pain, vomiting, or blood in the urine
- A severe allergic reaction: facial swelling, breathing difficulty, or widespread rash
Storage
Keep in the original package, away from moisture and direct heat, and out of children's reach. Follow the temperature limit on your pack and do not use it after the expiry date.
What to expect
For the selected indication, fosfomycin is given as a single dose. Contact your clinician if symptoms persist or worsen.
Sources
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