Pregnancy Category: B
ClassificationTherapeutic: anti infectives
Uncomplicated urinary tract infections in women (acute cystitis).
Inactivates an enzyme crucial for bacterial cell wall synthesis.
Decreases adherence of bacteria to uroepithelial cells.
Bactericidal action against susceptible bacteria.Active against: Enterococcus faecalis and Escherichia coli.
Absorption: Rapidly absorbed and converted to fosfomycin, its active component, resulting in 37% bioavailability.
Distribution: Distributes to kidneys and bladder wall; crosses the placenta.
Metabolism and Excretion: Excreted unchanged in urine (38%) and feces (18%).
Half-life: 5.7 hr.
Time/action profile (bactericidal urine levels†)
Contraindicated in: Hypersensitivity; Pyelonephritis; Lactation: Lactation.
Use Cautiously in: Obstetric / Pediatric: Pregnancy or children <12 yr (safety not established).
Adverse Reactions/Side Effects
Central nervous system
- pseudomembranous colitis (life-threatening)
Drug-Drug interactionUrinary excretion and blood levels are decreased by metoclopramide.
Oral (Adults and Children ≥18 yr) 3 g single dose.
Sachet: 3 g
- Assess patient for signs and symptoms of cystitis (frequency, urgency, painful urination).
- Obtain urine specimen for culture and sensitivity before administration.
- Monitor bowel function. Diarrhea, abdominal cramping, fever, and bloody stools should be reported to health care professional promptly as a sign of pseudomembranous colitis. May begin up to several weeks following cessation of therapy.
Potential Nursing DiagnosesRisk for infection (Indications)
Acute pain (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)
- Oral: Do not take medication in dry form. Pour entire contents of single sachet into 3–4 oz (½ cup) water and stir to dissolve. Do not use hot water. Drink immediately after mixing. May be administered with or without food.
- Instruct patient on correct preparation of sachet.
- Instruct patient to notify health care professional immediately if diarrhea, abdominal cramping, fever, or bloody stools occur and not to treat with antidiarrheals without consulting health care professionals.
- Advise patient to notify health care professional if symptoms have not improved or persist more than 2–3 days after treatment.
- Improvement in symptoms of acute cystitis within 2–3 days.