Neisseria gonorrhoeae and fosfomycin: Past, present and future

Int J Antimicrob Agents. 2015 Sep;46(3):290-6. doi: 10.1016/j.ijantimicag.2015.05.007. Epub 2015 Jun 19.

Abstract

Drug-resistant Neisseria gonorrhoeae has become a global health concern that requires immediate attention. Due to increasing resistance to cephalosporins, pursuing novel alternatives for treating N. gonorrhoeae infections is paramount. Whilst new drug development is often cumbersome, reviving antiquated antibiotic agents for treatment of modern infections has become prevalent in clinical practice. Fosfomycin exhibits bactericidal activity through a unique mechanism of action, and a variety of organisms including N. gonorrhoeae are susceptible. In vitro studies have demonstrated that fosfomycin can retain activity against ceftriaxone-resistant N. gonorrhoeae; however, it remains unclear whether there is synergy between fosfomycin and other antibiotics. Clinical investigations evaluating fosfomycin for the treatment of N. gonorrhoeae infections are confounded by methodological limitations, none the less they do provide some perspective on its potential role in therapy. Future studies are needed to establish a safe, convenient and effective fosfomycin regimen for treating N. gonorrhoeae infections.

Keywords: Fosfomycin; Gonorrhoea; In vitro; Multidrug-resistant; Neisseria gonorrhoeae.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use*
  • Fosfomycin / pharmacology*
  • Fosfomycin / therapeutic use*
  • Gonorrhea / drug therapy*
  • Gonorrhea / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae / drug effects*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Fosfomycin