Every year in the United States, hundreds of thousands of people are hospitalized with complicated urinary tract infections caused by bacteria that have become resistant to most oral antibiotics — a category called ESBL-producing Enterobacterales. These infections currently require intravenous carbapenem antibiotics, typically delivered in a hospital or infusion center, because there are so few effective oral alternatives.
A randomized clinical trial published in Clinical Infectious Diseases and reported by CIDRAP has found that oral fosfomycin is noninferior to IV carbapenem antibiotics when used as a step-down or transition therapy for these drug-resistant infections — a finding that could meaningfully reduce both hospital stays and health care costs for one of the most common and increasingly troubling categories of antibiotic-resistant infection.
