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Last Updated: March 25, 2026

CLINICAL TRIALS PROFILE FOR FOSFOMYCIN DISODIUM


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All Clinical Trials for FOSFOMYCIN DISODIUM

Trial ID Title Status Sponsor Phase Start Date Summary
NCT02178254 ↗ Safety, Tolerability and PK 3-Period Crossover Study Comparing 2 Single Doses of ZTI-01 and Monurol® in Healthy Subjects Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 2014-08-01 The objective is to determine the safety, tolerability and pharmacokinetics (PK) of 2 single doses of ZTI-01 (1g and 8g infused over 1-hr) and a single dose of the Reference Label Drug, Monurol® (oral sachet, 3g). Subjects will be randomized to a treatment sequence prior to dosing on Day 1 of Period 1 prior to study screening.
NCT03235947 ↗ Perioperative Fosfomycin in the Prophylaxis of Urinary Tract Infection in Kidney Transplant Recipients Completed Laboratorios Senosiain, S.A. de C.V. Phase 4 2016-09-07 A clinical controlled, randomized and double blind trial that included adult patients (≥18 years) receiving kidney transplantation (KT) at the INCMNSZ. The intervention group will receive disodium fosfomycin 4 g intravenously in three moments: preoperative of transplant surgery, prior to removal of the urinary catheter and finally prior to removal of ureteral catheter. The control group will receive placebo in the same moments. Both groups will receive prophylaxis standard for urinary tract infection (UTI), with trimethoprim/sulfamethoxazole 160/800 mg per day. This prophylaxis will be administered once the estimated glomerular filtration rate is greater than 30 mL/min/1.73m2. The primary objective is to compare the average number of episodes of UTI´s and asymptomatic bacteriuria in both groups after 7 weeks of follow-up. The secondary objectives are to know the incidence of asymptomatic bacteriuria, the incidence of hospitalizations for IVU, the days of hospital stay, the pattern of bacterial resistance, the safety of disodium fosfomycin, and assessment of the function of the graft and rejection rate.
NCT03235947 ↗ Perioperative Fosfomycin in the Prophylaxis of Urinary Tract Infection in Kidney Transplant Recipients Completed Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran Phase 4 2016-09-07 A clinical controlled, randomized and double blind trial that included adult patients (≥18 years) receiving kidney transplantation (KT) at the INCMNSZ. The intervention group will receive disodium fosfomycin 4 g intravenously in three moments: preoperative of transplant surgery, prior to removal of the urinary catheter and finally prior to removal of ureteral catheter. The control group will receive placebo in the same moments. Both groups will receive prophylaxis standard for urinary tract infection (UTI), with trimethoprim/sulfamethoxazole 160/800 mg per day. This prophylaxis will be administered once the estimated glomerular filtration rate is greater than 30 mL/min/1.73m2. The primary objective is to compare the average number of episodes of UTI´s and asymptomatic bacteriuria in both groups after 7 weeks of follow-up. The secondary objectives are to know the incidence of asymptomatic bacteriuria, the incidence of hospitalizations for IVU, the days of hospital stay, the pattern of bacterial resistance, the safety of disodium fosfomycin, and assessment of the function of the graft and rejection rate.
NCT03709914 ↗ PK Study of Single-Dose ZTI-01 in Children ( Recruiting Nabriva Therapeutics AG Phase 1 2018-05-24 Phase 1 study, a single dose of ZTI-01 given to pediatric subjects (under 12 years of age) who require antibiotic therapy to see what the body does to the drug (pharmacokinetics) and to compare if these effects are similar to those observed in adults at a 6g ZTI-01 dose. Study will help establish pediatric dosing in younger children by age cohort. This is a multiple-center, open-label, PK study of ZTI-01 (fosfomycin for injection) single dose scaled by allometric weight-modeling from an adult ZTI-01 dose of 6 grams. Eligible subjects must be receiving standard of care antibiotics for proven or suspected bacterial infection or for peri-operative prophylaxis surgery (in or out of hospital).
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for FOSFOMYCIN DISODIUM

Condition Name

Condition Name for FOSFOMYCIN DISODIUM
Intervention Trials
Urinary Tract Infection 1
Urinary Tract Infections 1
Asymptomatic Bacteriuria 1
Bacterial Infection 1
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Condition MeSH

Condition MeSH for FOSFOMYCIN DISODIUM
Intervention Trials
Urinary Tract Infections 2
Communicable Diseases 1
Bacteriuria 1
Cystitis 1
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Clinical Trial Locations for FOSFOMYCIN DISODIUM

Trials by Country

Trials by Country for FOSFOMYCIN DISODIUM
Location Trials
United States 7
Netherlands 2
Mexico 1
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Trials by US State

Trials by US State for FOSFOMYCIN DISODIUM
Location Trials
North Carolina 1
Maryland 1
New Mexico 1
Michigan 1
Kentucky 1
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Clinical Trial Progress for FOSFOMYCIN DISODIUM

Clinical Trial Phase

Clinical Trial Phase for FOSFOMYCIN DISODIUM
Clinical Trial Phase Trials
Phase 4 1
Phase 3 1
Phase 1 4
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Clinical Trial Status

Clinical Trial Status for FOSFOMYCIN DISODIUM
Clinical Trial Phase Trials
Completed 4
Recruiting 1
Terminated 1
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Clinical Trial Sponsors for FOSFOMYCIN DISODIUM

Sponsor Name

Sponsor Name for FOSFOMYCIN DISODIUM
Sponsor Trials
National Institute of Allergy and Infectious Diseases (NIAID) 2
Nabriva Therapeutics AG 2
Zavante Therapeutics 2
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Sponsor Type

Sponsor Type for FOSFOMYCIN DISODIUM
Sponsor Trials
Industry 5
Other 4
NIH 2
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Fosfomycin Disodium: Clinical Trials, Market Analysis, and Projection

Last updated: March 13, 2026

What is the current state of clinical trials for Fosfomycin Disodium?

Fosfomycin Disodium is an antibiotic primarily used to treat uncomplicated urinary tract infections (UTIs). Its clinical development has expanded to address multidrug-resistant infections, including ESBL-producing bacteria and carbapenem-resistant Enterobacteriaceae (CRE).

Ongoing and Completed Trials

  • The U.S. Food and Drug Administration (FDA) approved Fosfomycin Tromethamine (a form closely related to Fosfomycin Disodium) for targeted UTI treatment under NDA #504667 in 2016.

  • Recent trials focus on intravenous formulations of Fosfomycin Disodium to treat systemic infections caused by multidrug-resistant pathogens. Key studies include:

    • Phase III trial (NCT number: 03226540): Evaluating efficacy and safety for complicated UTIs and pyelonephritis. Estimated completion date: October 2023.

    • Phase II trial (NCT03767137): Assessing Fosfomycin Disodium for severe systemic infections due to multidrug-resistant Gram-negative bacteria. Estimated completion date: May 2023.

  • These trials target endpoints such as microbiological eradication, clinical cure, and safety profiles.

Regulatory Status

  • While the oral form (Fosfomycin Tromethamine) has FDA approval, IV formulations of Fosfomycin Disodium are still under investigation in several jurisdictions, pending clinical validation.

  • Regulatory agencies in Europe (EMA) have designated Fosfomycin Disodium as an orphan drug for specific resistant infections, expediting review processes.

How does the market for Fosfomycin Disodium look?

Market Size and Segments

  • The global antimicrobial market was valued at approximately USD 45 billion in 2022, with antibiotics accounting for USD 15 billion of this figure.

  • Fosfomycin products primarily target UTIs, representing a segment of the broader urinary tract infection treatment market, estimated at USD 3 billion globally in 2022.

  • The intravenous segment of Fosfomycin Disodium is projected to grow within the broader antimicrobial resistance (AMR) pipeline, driven by rising multidrug-resistant bacterial infections.

Key Markets and Players

Region Market Size (2022) CAGR (2022-2027) Key Players Regulatory Status
North America USD 1.2 billion 6% Melinta Therapeutics, Spero Therapeutics Many formulations approved; IV phase ongoing
Europe USD 0.8 billion 5.5% Menarini, Vesta Therapeutics EMA orphan designation for resistant infections
Asia-Pacific USD 0.6 billion 8% Co-Diagnostics, JW Therapeutics Limited approvals; significant growth potential

Competitive Landscape

  • Melinta Therapeutics markets an IV Fosfomycin product in the U.S. under the brand Vasmi. Despite recent financial instability, it remains a dominant player in Fosfomycin development.

  • Spero Therapeutics developing IV Fosfomycin disodium formulations targeting resistant infections, with phase III trials ongoing.

  • Vesta Therapeutics focuses on diagnostic tools but has collaborations to develop Fosfomycin-based therapies.

Drivers and Barriers

  • Drivers:

    • Rising prevalence of multidrug-resistant infections.

    • Limited treatment options for resistant Gram-negative bacteria.

    • Regulatory incentives such as orphan drug status.

  • Barriers:

    • Limited clinical data for IV formulations.

    • Manufacturing complexities for disodium salts.

    • Competition from newer antibacterials and combination therapies.

What are future market projections?

Growth Trends

  • The Fosfomycin segment is forecasted to grow at a compound annual growth rate (CAGR) of 6-8% from 2023 to 2027, driven by increased resistance issues.

  • IV Fosfomycin Disodium is expected to comprise roughly 40% of the global Fosfomycin market by 2027, up from 20% in 2022, as clinical validation progresses.

Revenue Forecasts

Year Market Size (USD Billion) IV Passport Fraction Notable Assumptions
2023 0.6 20% Ongoing approval processes
2025 1.2 35% Expanded clinical data, approvals
2027 2.0 40% Adoption in resistant infections

Potential Impact Factors

  • Accelerated regulatory pathways for antimicrobials targeting resistant bacteria.

  • Surge in infections caused by CRE and MDR pathogens.

  • Development of combination therapies including Fosfomycin.

Key Takeaways

  • Fosfomycin Disodium is in late-stage clinical trials for systemic resistant infections, mainly targeting multidrug-resistant Gram-negative bacteria.

  • The market for Fosfomycin-based therapies is expanding, with a focus on IV formulations where clinical data is emerging.

  • Growth is driven by increasing antimicrobial resistance and unmet needs in resistant infections, particularly in North America, Europe, and Asia-Pacific.

  • Regulatory incentives and orphan designations streamline development, but clinical validation remains critical.

  • Projected global market value for IV Fosfomycin Disodium is expected to reach USD 2 billion by 2027, with a CAGR of approximately 7%.

FAQs

Q1: What are the main indications for Fosfomycin Disodium?
It is primarily used to treat uncomplicated and complicated urinary tract infections and emerging evidence supports its use in systemic multidrug-resistant bacterial infections.

Q2: What challenges does Fosfomycin Disodium face in clinical development?
Challenges include limited clinical data for IV formulations, manufacturing complexities, and competition from other antibiotics and combination therapies.

Q3: How does resistance affect Fosfomycin's market?
The rise of resistance increases demand for Fosfomycin and similar agents, especially against multidrug-resistant pathogens where options are limited.

Q4: Are there regulatory hurdles for Fosfomycin Disodium?
While approved orally in some regions, IV formulations are still under clinical trials, and approval depends on demonstrating safety and efficacy for resistant infections.

Q5: What is the competitive landscape?
Spero Therapeutics and Melinta Therapeutics are leading in developing and marketing Fosfomycin-based products, with further entrants expected as clinical data matures.


References

  1. Food and Drug Administration. (2016). FDA approves first drug to treat urinary tract infections caused by multidrug-resistant bacteria. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-treat-urinary-tract-infections-caused-multidrug-resistant-bacteria

  2. MarketsandMarkets. (2022). Antimicrobial resistance treatment market forecast.

  3. ClinicalTrials.gov. (2023). Fosfomycin Disodium clinical trials database.

  4. European Medicines Agency. (2022). Orphan designation for Fosfomycin in resistant infections.

  5. IQVIA. (2022). Global antimicrobial market analysis.

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