meropenem + fosfomycin

**Meropenem + fosfomycin** is a combination of two intravenous antibiotics used primarily to treat severe, multidrug-resistant Gram-negative bacterial infections, including infections caused by *Klebsiella pneumoniae* and *Pseudomonas aeruginosa*. Meropenem is a broad-spectrum carbapenem that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell lysis and death[2]. Fosfomycin is a unique bactericidal antibiotic that irreversibly inhibits the enzyme UDP-N-acetylglucosamine enolpyruvyl transferase (MurA), blocking the first step in bacterial peptidoglycan biosynthesis and thus cell wall formation[5][8]. Together, this combination has been shown to be synergistic, achieving enhanced bacterial killing and suppressing emergence of resistance compared to monotherapy, especially against carbapenem-resistant and high-burden infections[4][7][10]. This regimen is under investigation and increasingly utilized in critical care settings for multidrug-resistant pathogens.

Other names

meropenem/fosfomycin