Recent publication: Intravenous fosfomycin potential in Canada and it’s role with MDR pathogens.

Toronto, Ontario (July 11, 2018) – A new clinical publication, Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada, has recently been published in the Canadian Journal of Infectious Diseases and Medical Microbiology.

The paper, published on June 25th, was authored by Dr. George Zhanel, Michael A. Zhanel, and Dr. James A. Karlowsky at the Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba in Winnipeg, Manitoba.


Examining the current multi drug resistant Canadian landscape

Utilizing the CANWARD* Surveillance Study 2,3, the current state of antimicrobial resistant infections and the need for new antimicrobial agents in Canada is presented. A thorough analysis of Intravenous Fosfomycin including its long history in Europe, unique mechanism of action, and activity against Gram-positive and Gram-negative bacteria was also performed.


Meeting an unmet medical need in multi drug resistant infections

Further examination and assessments of resistance mechanisms, prevalence of resistance, clinical trials and clinical utility led to a determination that availability of intravenously administered fosfomycin in Canada revolves primarily around its potential use in treating hospitalized patients with MDR Gram-positive and MDR Gram-negative infections not responding to other antimicrobial agents and/or for patients who cannot tolerate first- and/or second-line agents due to adverse effects. Using fosfomycin in combination with another antimicrobial should limit the development of resistance to this agent over time. Because of its proven safety, it should be considered for use in preference to last line toxic agents such as colistin, tigecycline, and aminoglycosides. In addition, due to its exceptional tissue distribution it could be used not only for the most common infections such as bacteremia, urinary tract, skin and soft tissue, and respiratory infections but also for difficult to treat infections such as bone infections, meningitis, invasive ocular infections, and cUTI.

Noting that Intravenous Fosfomycin is listed among the World Health Organization’s RESERVE group of antibacterial medicine, the paper also goes on to state that Intravenous Fosfomycin could play a role in Canadian hospitals as therapy for patients with infections who have not responded to first- and potentially second-line antimicrobials or in patients who cannot tolerate (due to adverse effects) first- and second-line antimicrobials.

“Whether in Canada or worldwide, hospitals are facing the growing presence of infections caused by antimicrobial-resistant, multidrug-resistant (MDR), and extensively-drug-resistant (XDR) pathogens.This new paper underscores the urgent need for new antimicrobials in Canada, and suggests that Intravenous Fosfomycin will be a valued agent for infectious disease experts to consider.” – Dr. Neil Fleshner MD, MPH, FRCSC, Chief Medical Officer, Verity Scientific Advisory Board.

For further review, the entire paper, ‘Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada’ can be accessed at this link:

*The Canadian Antimicrobial Resistance Alliance (CARA), CANWARD Study.



  1. Zhanel GG, Zhanel MA, Karlowsky JA. Intravenous Fosfomycin: An Assessment of Its Potential for Use in the Treatment of Systemic Infections in Canada. Canadian Journal of Infectious Diseases and Medical Microbiology;Volume 2018, Article ID 8912039
  2. Zhanel GG, DeCorby M, Adam H et al. Prevalence of antimicrobial resistant pathogens in Canadian hospitals: Results of the Canadian ward surveillance study (CANWARD 2008). Antimicrob Agents Chemother 2010; 54: 4684-93.
  3. Zhanel GG, Adam HJ, Baxter M et al. Antimicrobial susceptibility of 42,938 pathogens isolated from patients in Canadian hospitals. CANWARD study 2007-2016. American Society for Microbiology (ASM) Microbe, New Orleans, LA, 2017.