University of Nebraska Medical Center

Fosfomycin (Monurol)

The Pharmacy and Therapeutics Committee voted to add Fosfomycin (Monurol®) to the inpatient formulary with Antimicrobial Restrictions, effective May 1, 2011. In order to make this medication available as a formulary agent for the general medical staff and to ensure appropriate usage, the Pharmacy and Therapeutics Committee has approved the following restrictions to fosfomycin use:

  1. Single dose fosfomcyin for simple cystitis in uncomplicated UTIs can be used without restriction
  2. Use for any other indication or duration requires documented sensitivity to the agent
    1. Bacterial isolates are not routinely tested for susceptibility to fosfomycin but susceptibility testing is available by request in the microbiology laboratory (Please contact 552-2090 if this is desired)
    2. The agent will not be dispensed for use until susceptibility has been documented
    3. Interpretive standards for susceptibility to fosfomycin are only available for E. coli and Enterococcus faecalis.
  3. An ID consult is strongly recommended for all uses outside of simple cystitis

Fosfomycin Drug Review