Fosfomycin: what was old is new again

With the rising prevalence of antibiotic resistance in bacteria, there is a need to develop new antibiotics and re‐visit older antibiotics where there are no available alternatives. Fosfomycin, first discovered in the 1960s,1 has a long history of use in some countries (including the United States, Japan and several European countries), particularly for urinary tract infections.2 In Australia, oral fosfomycin trometamol, previously only available through the Special Access Scheme, has recently been approved by the Therapeutic Goods Administration for the management of acute, uncomplicated urinary tract infections in females over 12 years of age, caused by Enterobacteriaceae (including Escherichia coli) and Enterococcus faecalis, where the standard recommended agents are not effective. Currently, it is not subsidised by the Pharmaceutical Benefits Scheme.