Question

Fosfomycin is given as a large single dose to treat which infection? (A) gonorrhea (B) syphilis (C) urinary tract infection (D) impetigo (E) traveler's diarrhea

Short answer

(C) urinary tract infection

Step-by-step solution

Understanding the Medication

Fosfomycin is an antibiotic that is often administered as a large single dose. It is primarily used to treat bacterial infections by inhibiting cell wall synthesis in bacteria.

Identifying Common Uses

Fosfomycin is commonly used to treat uncomplicated urinary tract infections (UTIs). Its effectiveness lies in its ability to concentrate in the urinary tract, where it works efficiently against bacteria causing these infections.

Linking to the Options

Examining the options provided: gonorrhea, syphilis, urinary tract infection, impetigo, and traveler's diarrhea, fosfomycin is not typically used to treat gonorrhea, syphilis, impetigo, or traveler's diarrhea.

Finding the Solution

The correct treatment use for fosfomycin as a large single dose based on the options given is for urinary tract infections (UTIs), making this the correct answer.

Key concepts

Antibiotic Usage

Antibiotics are medicinal substances used to treat bacterial infections. They work by targeting specific processes essential for bacterial survival and proliferation. While antibiotics have revolutionized healthcare, precise usage is crucial for their effectiveness. Overuse or misuse of antibiotics can lead to serious problems, such as antibiotic resistance. Antibiotic therapy should be tailored to the specific type of bacteria causing the infection. It involves understanding various factors like the antibiotic's spectrum of activity, its safety profile, and the patient's medical history. Fosfomycin is an example of an antibiotic used selectively for specific infections due to its mechanism of action. Proper antibiotic usage involves:

• Ensuring the correct antibiotic is chosen for the infection.
• Following prescribed doses and treatment schedules.
• Avoiding unnecessary use of antibiotics.
• Educating patients about the importance of adherence to prescribed treatments.

Urinary Tract Infections

Urinary tract infections (UTIs) are common infections that occur when bacteria enter the urinary tract. This can cause symptoms like pain during urination, frequent urge to urinate, and discomfort in the lower abdomen. Women are particularly susceptible to UTIs due to anatomical differences, but they can affect anyone. UTIs are typically classified as uncomplicated or complicated:

• Uncomplicated UTIs: These occur in otherwise healthy individuals without underlying urological abnormalities. Usually, a short course of antibiotics is effective.
• Complicated UTIs: These occur in individuals with urinary tract abnormalities or those with a catheter, making treatment more challenging.

It’s important to diagnose UTIs accurately through symptoms and laboratory tests, like urine analysis, to identify the presence of bacteria.

Cell Wall Synthesis Inhibition

The cell wall is a crucial component of bacterial cells, providing structural support and protection. Antibiotics that inhibit cell wall synthesis are effective because they weaken the bacterial cell wall, leading to the death of the bacteria. Fosfomycin falls into this category. Fosfomycin works by hindering the first step in bacterial cell wall synthesis. It inhibits an essential enzyme, called enolpyruvyl transferase, which acts early in the process of building the bacterial cell wall. By blocking this enzyme, fosfomycin prevents the formation of peptidoglycan, a key substance that gives the cell wall its strength and rigidity. Without a functional cell wall, bacteria cannot survive in the human body’s environment, leading to their elimination. This mechanism of action makes fosfomycin an effective treatment against a variety of bacteria that cause UTIs.

Fosfomycin Treatment

Fosfomycin is primarily used for treating uncomplicated urinary tract infections (UTIs) caused by susceptible bacteria. One of its key benefits is its unique dosing regimen—a large single dose that is convenient for patients and helps ensure adherence to treatment. The drug's ability to concentrate effectively in the urinary tract makes it a suitable option for UTI treatment. It maintains therapeutic levels within the urinary system for a period long enough to combat the infection effectively. Moreover, fosfomycin is usually well-tolerated with a low risk of side effects. Patients should always follow medical advice when using fosfomycin. It is administered orally, often as a single sachet mixed in water, providing a simple treatment course that does not require prolonged dosing. This advantage is particularly beneficial in situations where maintaining patient compliance is critical.