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ν¬μ€ν¬λ§μ΄μ μ λ νΉν ν©μ± κ΄λ²μ **ν¬μ€ν°μ° μ λ체 νμμ **μ λλ€. μλ *Streptomyces fradiae*μμ λΆλ¦¬λμμΌλ©°, μΈμμμλ μ£Όλ‘ λ¨μ μλ‘κ°μΌ(UTI)μ λ¨ν ν¬μ¬ μΉλ£μ λ‘ μ¬μ©λ©λλ€. μμνμμ μ΄ μ½λ¬Όμ μ¬μ©μ λ§€μ° μ€νμ μ΄μ§λ§, λ€μκ³Ό κ°μ κ²½μ°μ 'ꡬμ ' λλ μλΉ νκ· μ λ‘ μ£Όλͺ©λ°κ³ μμ΅λλ€: - **λ€μ λ΄μ±(MDR) λμ₯κ· (*Escherichia coli*)** - **κ΄λ²μ λ² νλ½νλ§μ (ESBL) μμ± μ₯λ΄μΈκ· κ³Ό** - λμΉμ± μ₯κ΅¬κ· κ°μΌ **μμ μμ :** - μ£Όλ‘ **μκ° μμ‘΄μ ** μ΄κ· μ μ΄μ§λ§, μΌλΆ λλ μμ‘΄μ νΉμ±λ λνλ λλ€. - λ² νλ½νκ³ λλ μλ―Έλ ΈκΈλ¦¬μ½μ¬μ΄λκ³μ κ΅μ°¨ λ΄μ±μ΄ μΌλ°μ μΌλ‘ λ°μνμ§ μμ νμ€ 1μ°¨ νμμ κ° μ€ν¨ν λ κ°μΉ μλ μ νμ§κ° λ©λλ€. - **μ€μ:** λ―Έκ΅μμ μνλλ κ²½κ΅¬μ© μ μ λ *νΈλ‘λ©νλ―Ό* μΌμΈ λ°λ©΄, λ§μ μμν μ½λν μ°κ΅¬μμλ *μ΄λνΈλ₯¨* μΌ(λΉκ²½κ΅¬ ν¬μ¬μ©)μ μ¬μ©νμ΅λλ€.
μμ© κΈ°μ : Fosfomycin exerts its bactericidal effect by interfering with the very first step of bacterial cell wall (peptidoglycan) synthesis. - It acts as a structural analogue of phosphoenolpyruvate (PEP). - It irreversibly binds to and inhibits the cytosolic enzyme **MurA (UDP-N-acetylglucosamine enolpyruvyl transferase)**. - **Pathway:** Blocks addition of PEP to UDP-N-acetylglucosamine β Prevents formation of **uridine diphosphate-N-acetylmuramic acid (UDP-MurNAc)** β Halts peptidoglycan synthesis β Bacterial cell lysis. - **Secondary Action:** It also reduces the adherence of bacteria to uroepithelial cells, which is highly beneficial in treating UTIs. - **Resistance Mechanism:** When resistance occurs, it is typically chromosomally mediated via the production of **FosA** or **FosX** enzymes, which hydrolyze and inactivate the drug.
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- Susceptible infections (Investigational) Β· 20 mg/kg Β· SC Β· q10h Β· Unknown Β· Based on PK study using fosfomycin disodium (not commercially available in USA). May maintain effective plasma concentrations for up to 10 hours.
- Urinary Tract Infection (MDR E. coli) Β· 40 mg/kg Β· PO Β· Single dose Β· Single dose Β· Investigational. Dose based on disodium salt in a PK study. Use should be prudently reserved for MDR E. coli based on susceptibility testing only when no other alternative exists.
μ©λμ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μ°Έκ³ μλ£μ λλ€. νμ μ΅μ λΌλ²¨κ³Ό κ°λ³ νμμ λν΄ νμΈνμμμ€.
ν¬μ¬ κ²½λ‘
κΈκΈ°
- Young cats (Contraindicated due to nephrotoxicity)
- Adult cats (Relative contraindication; use with extreme caution if at all)
μ΄μλ°μ
- Diarrhea (most common in humans)
- Gastrointestinal upset
- Renal tubular damage / Nephrotoxicity (observed in cats)
μ½λ¬Ό μνΈμμ©
- Metoclopramide Β· Can decrease serum concentrations and reduce urine levels of fosfomycin.
- Prokinetic agents (bethanechol, cisapride, domperidone, ranitidine, laxatives) Β· Theoretical risk of decreasing serum and urine concentrations by increasing GI motility, similar to metoclopramide.
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- Gastrointestinal adverse effects (diarrhea)
- Clinical signs of UTI resolution
- Urine culture and susceptibility (pre- and post-treatment)
- Urinalysis
- Renal function tests (BUN, Creatinine) especially if used off-label in cats
κ³Όμ©λ
Single overdoses are most likely to cause **gastrointestinal effects** (e.g., severe diarrhea). In cats, overdosage or even standard doses can cause severe **nephrotoxicity** (tubular necrosis). Treatment should be supportive and symptomatic.
VetSheet μ½λ¬Ό λ νΌλ°μ€λ λ©΄ν μμ μ λ¬Έκ°λ₯Ό μν μμ μμ¬κ²°μ 보쑰 λꡬμ΄λ©°, μ λ¬Έμ νλ¨μ΄λ μ μ‘°μ¬μ μ΅μ λΌλ²¨μ λμ νμ§ μμ΅λλ€.