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Official websites use. Share sensitive information only on official, secure websites. Correspondence: K. Poster ZTI fosfomycin for injection is an epoxide antibiotic with a differentiated mechanism of action MOA inhibiting an early step in bacterial cell wall synthesis. ZTI has broad in vitro spectrum of activity, including multidrug-resistant Gram-negative pathogens, and is being developed for treatment of complicated urinary tract infection cUTI and acute pyelonephritis AP in the United States.

Clinical cure rates at test of cure TOC, day 19—21 were high and similar between treatments ZTI was well tolerated. Most treatment-emergent adverse events, including hypokalemia and elevated serum aminotransferases, were mild and transient. Keywords: ZTI, fosfomycin, complicated urinary tract infection, acute pyelonephritis. ZTI was non-inferior to piperacillin-tazobactam and was well tolerated. See the Editorial Commentary by Harris on pages —8. Prevalence of drug resistance has increased steadily resulting in the need for safe and effective antibiotic treatment options, particularly for multidrug-resistant MDR Gram-negative bacteria [ 1 ].

As rates of serious infections intensify, clinicians are forced to use agents of last resort or agents associated with toxicity eg, polymyxins, aminoglycosides. ZTI fosfomycin for injection is an injectable epoxide and sole antibiotic class member. The differentiated MOA inhibits an early step in peptidoglycan biosynthesis by covalently binding to MurA [ 3 ].

In in vitro studies, ZTI has demonstrated a broad spectrum of activity against a variety of clinically important MDR Gram-negative pathogens including extended-spectrum beta-lactamase [ESBL]-producing Enterobacteriaceae and carbapenem-resistant Enterobacteriaceae [CRE] and Gram-positive pathogens including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci [ 4 ].