Prospects of oral fosfomycin for the treatment of chronic bacterial prostatitis

The most frequent causative agent of chronic bacterial prostatitis is Escherichia coli , however, in recent years, the proportion of other gram-negative and gram-positive microorganisms in the structure of pathogens has been increasing. There is not only an increase in the proportion of extended-spectrum β-lactamases producing Escherichia coli , which ensures the resistance of bacteria to penicillins, cephalosporins and aztreonam, but also carbapenemases producing strains. The tendency of increasing resistance of uropathogens to fluoroquinolones is noted. An alternative for the treatment of bacterial prostatitis may be fosfomycin, which is due to its high bioavailability when taken orally and the ability to reach high concentrations in the prostate. This review examines the mechanisms of action of fosfomycin, the features of its pharmacokinetics in the prostate gland, the antimicrobial spectrum and the mechanisms of resistance to fosfomycin of uropathogens. The results of oral fosfomycin for the treatment of chronic bacterial prostatitis are discussed.