Dosing
It comes in the ever so quaint sachet.
Women: years: 3 g PO once. I suspect this is insufficient and likely need 3 or more doses, which is why it was inferior to nitrofurantoin for UTI (PubMed).
Males: 3 g every 2-3 days for 3 doses
IV is 8-24 grams a day.
Important side effects
IV has a lot of sodium.
Important drug interactions
Rants and Screeds
Pearls
Can be synergistic with beta-lactams.
Effective against E. faecalis, E. coli, Citrobacter and Proteus. Pseudomonas may have more ability to be resistant, but less perhaps than other antibiotics.
May be useful with MDRO and XDR (PubMed).
Resistance is rare in the US but common in China. US resistance variable, more in Klebsiella than E. coli (Review)
Treatment of choice
Use for
UTI (PubMed). Maybe prostatitis.
Don't use for
Pyelonephritis
Class
phosphonic acid derivative it inhibits bacterial cell wall synthesis
Curious Cases
Relevant links to my Medscape blog