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The phosphonic acid containing a structurally strained and reactive epoxide ring confers broad spectrum, bactericidal activity against gram\u2010positive and gram\u2010negative bacteria. Fosfomycin's small size and hydrophilicity permits broad tissues penetration. Although only fosfomycin tromethamine oral is approved for urinary tract infections (UTI) in the United States since 1996, the intravenous form has been utilized worldwide for over four decades. The increasing rates of multidrug\u2010resistant (MDR) infections with few novel treatment options available has spurred the recent interest in fosfomycin. Fosfomycin's high urinary concentration, broad spectrum of activity against MDR pathogens, and favorable safety profile offers a valuable oral option for treating UTI, one of the most common bacterial infections in childhood. The ability of fosfomycin to penetrate biofilm and reported activity against intracellular pathogens may further its importance in childhood diseases such as Chronic Granulomatous Disease, <jats:italic>Salmonellosis<\/jats:italic>, and <jats:italic>Listeriosis<\/jats:italic>. More data are needed to further define optimal Pharmacodynamic target, as well as Pharmacokinetic, safety and outcomes for repeated oral and intravenous dosing of fosfomycin in infants and children in systemic infections.<\/jats:p>","DOI":"10.1002\/phar.2780","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T04:24:11Z","timestamp":1677212651000},"page":"705-712","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["New ways of using old antibiotics in pediatrics: Focus on fosfomycin"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9593-4847","authenticated-orcid":false,"given":"Martin Tuan","family":"Tran","sequence":"first","affiliation":[{"name":"Children's Health of Orange County (CHOC)  Orange California USA"},{"name":"Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences University of California Irvine  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,4]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"WHO Strategic Priorities on Antimicrobial Resistance.Preserving antimicrobials for today and tomorrow. 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