Fosfomycin

General Information

Restricted formulary antimicrobial: For details see OUH netFormulary

Oral: AWaRe antibiotic classification: 'Access'. Use as per guidelines.

IV: AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.

Elderly patients - Caution is advised when considering the use of IV doses at the higher end of the recommended range (see also recommendations on dosage for patients with impaired renal function below).

For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).

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Renal impairment

Creatinine Clearance (ml/min)	Oral Dose	IV dose
41-80	Dose as in normal renal function	Dose as in normal renal function Caution should be exercised, particular if doses at higher end of the recommended range
31-40	Dose as in normal renal function	Normal loading dose (must not exceed 8g), then 70% of normal daily dose in 2-3 divided doses
21-30	Dose as in normal renal function	Normal loading dose (must not exceed 8g), then 60% of normal daily dose in 2-3 divided doses
11-20	Dose as in normal renal function	Normal loading dose (must not exceed 8g), then 40% of normal daily dose in 2-3 divided doses
Less than 10	Avoid	Normal loading dose (must not exceed 8g), then 20% of normal daily dose in 1-2 divided doses
HD/HDF/High Flux	Avoid	2g-4g post-dialysis
PD	Avoid	Normal loading dose (must not exceed 8g), then 20% of normal daily dose in 1-2 divided doses

Note: dose ranges use creatinine clearance, rather than eGFR.

Hepatic impairment
No dose adjustment required in hepatic impairment.

Summary of Product Characteristics (SPC) for Fomicyt 40 mg/ml powder for solution for infusion. Last updated 31/10/20. Accessed via www.medicines.org.uk on 6/11/21
Summary of Product Characteristics (SPC) for Monuril 3g granules for oral solution. Last updated 17/5/21. Accessed via www.medicines.org.uk on 6/11/21
The Renal Drug Database. Fosfomycin. Accessed via renaldrugdatabase.com 19/7/21. Last updated 17/4/18
BNF online accessed via www.medicinescomplete.com on 6/11/21

General Information

Renal and hepatic impairment

References

Editorial Information