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Urinary tract infection · TREATMENT GUIDE

Fosfomycin for urinary tract infections guide

This guide applies only when fosfomycin is prescribed for acute, uncomplicated cystitis in women or female adolescents over 12 years of age.

2 min read · Reviewed by Dr. Alejandro Infante
TREATMENT GUIDE · Urinary tract infection

Fosfomycin for urinary tract infections guide

This guide applies only when fosfomycin is prescribed for acute, uncomplicated cystitis in women or female adolescents over 12 years of age.

READ TIME
2 min read
PATHWAY
Fosfomycin
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This guide does not replace the package leaflet or your doctor's assessment.

Medicines and interactions to reviewMetoclopramide and other medicines that speed intestinal transit can reduce fosfomycin exposure

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On this page
01

How to use

  1. Take the sachet as a single dose

    Dissolve the 3 g sachet in a glass of water and drink it immediately. Take it on an empty stomach, preferably before bedtime after emptying your bladder.

  2. Use only for the selected infection

    The single-dose regimen is for acute uncomplicated cystitis in the selected patient group. It is not the regimen for a kidney infection, a complicated UTI, or a UTI in a male patient.

Monitoring

Medicines and interactions to review. Metoclopramide and other medicines that speed intestinal transit can reduce fosfomycin exposure

02

Treatment pathway

See the full decision pathway

Protocol pathway

    • Confirm a localised lower UTI

      Fever, chills, flank pain, vomiting, pregnancy, or systemic illness require another care pathway.

    • Use the selected prescription

      The protocol prioritises fosfomycin 3 g once. Nitrofurantoin modified release 100 mg every 12 hours for 5 days is the alternative only when fosfomycin is unsuitable and nitrofurantoin is safe.

    • Review at 48 hours if not improving

      Do not switch antibiotics automatically. A urine culture or in-person review may be needed.

03

Dose schedule

  1. Single-dose treatment

    The authorised regimen is one 3 g dose. Contact a clinician promptly if symptoms do not begin to improve or if they worsen.

  2. Seek review for warning symptoms

    Fever, chills, pain in the back or side, vomiting, or worsening symptoms need prompt clinical review because they may indicate an infection outside this guide's scope.

04

Side effects

Gastrointestinal effects

Diarrhoea, nausea, indigestion, and abdominal pain are most common. Usually mild and short-lived.

Other possible effects

Headache, dizziness, and vaginal itching. Allergic skin reactions are uncommon.

05

Do not use if

  • You are allergic to fosfomycin
  • You have fever, chills, flank pain, vomiting, or feel systemically unwell
  • The infection is complicated, you are pregnant, or this guide's selected patient group does not apply

If any item may apply, do not use the medicine until a clinician has reviewed it.

06

When to contact your doctor

  • Symptoms worsen or fail to improve, or you develop fever, chills, back pain, vomiting, or blood in the urine
  • A severe allergic reaction: facial swelling, breathing difficulty, or widespread rash
07

Storage

Keep in the original package, away from moisture and direct heat, and out of children's reach. Follow the temperature limit on your pack and do not use it after the expiry date.

08

What to expect

For the selected indication, fosfomycin is given as a single dose. Contact your clinician if symptoms persist or worsen.

09

Sources

  1. eMC: Fosfomycin SmPC
Urinary tract infectionThis guide is for patients whose doctor has already prescribed Fosfomycin.Questions about your treatment? Message your doctor from your account. Not on treatment yet? An EU-licensed doctor assesses your case and decides whether any treatment is appropriate.Start consultationThis guide does not replace the package leaflet or your doctor's assessment.
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Common questions

Fosfomycin for urinary tract infections guide3 questions
Who reviews the guides?
Each guide is reviewed by an EU-licensed doctor. It is based on the official product information, cited at the end of each guide.
No. They support your treatment, and your doctor's instructions always come first.
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The clinical information on this page was reviewed by: Dr. Alejandro Infante, General medicine, on 26 August 2026. Barcelona College of Physicians, no. 080869277 View profile

If the doctor does not approve treatment, we refund the full amount. Every consultation is fully refundable. How refunds work