Last reviewed 2026-05-28 · How we verify

Meropenem + Fosfomycin

Meropenem + Fosfomycin is a Combination antibiotic (carbapenem + phosphonic acid antibiotic) Small molecule drug developed by National University of Singapore. It is currently FDA-approved for Multidrug-resistant gram-negative bacterial infections (including Pseudomonas aeruginosa and Acinetobacter baumannii), Hospital-acquired and ventilator-associated pneumonia.

This combination uses meropenem (a broad-spectrum carbapenem) to inhibit bacterial cell wall synthesis, paired with fosfomycin (which inhibits cell wall precursor synthesis) to provide synergistic activity against resistant gram-negative bacteria.

Meropenem is a small molecule antibiotic used in combination with fosfomycin to treat various bacterial infections, including multi-antibiotic resistance, bloodstream infections, ventilator-associated bacterial pneumonia, hospital-acquired bacterial pneumonia, and carbapenem-resistant bacterial infections. The combination of meropenem and fosfomycin has been studied in clinical trials, including those for treating multidrug-resistant Gram-negative bacteria.

At a glance

Mechanism of action

Meropenem is a beta-lactam antibiotic that binds penicillin-binding proteins and disrupts peptidoglycan cross-linking in bacterial cell walls. Fosfomycin inhibits MurA, an early step in peptidoglycan synthesis. Together, they provide enhanced bactericidal activity and may overcome resistance mechanisms, particularly against multidrug-resistant gram-negative organisms such as Pseudomonas aeruginosa and Acinetobacter baumannii.

Approved indications

• Multidrug-resistant gram-negative bacterial infections (including Pseudomonas aeruginosa and Acinetobacter baumannii)
• Hospital-acquired and ventilator-associated pneumonia

Common side effects

• Nausea
• Diarrhea
• Headache
• Seizures (carbapenem-related)
• Phlebitis at injection site

Key clinical trials

• Pivmecillinam as Oral Step-Down Treatment for Escherichia Coli Febrile Urinary Tract Infection Versus Standard of Care (PHASE4)
• Optimising TREATment for Severe Gram-Negative Bacterial Infections (PHASE4)
• Pharmacokinetics, Pharmacodynamics, and Safety Profile of Understudied Drugs Administered to Children Per Standard of Care (POPS)
• Mortality of MBL-producing Enterobacteriaceae Bacteremias with the Combined Use of Ceftazidime-avibactam and Aztreonam Vs. Other Active Antibiotics. a Multicenter Target Trial Emulation.
• Efficacy and Safety of CAZ-AVI in the Treatment of Infections Due to Carbapenem-resistant G- Pathogens in Chinese Adults (PHASE4)
• Use of New Antibiotics in Sweden
• Drug Resistance Mechanism of Enterobacteriaceae and Its Strategies (NA)
• Patients Response to Early Switch To Oral:Osteomyelitis Study (EARLY_PHASE1)

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.

Competitive intelligence

For the full competitive landscape — auto-detected comparators, recent regulatory actions across the set, upcoming PDUFA, patent timeline, sponsor landscape:

• Meropenem + Fosfomycin CI brief — competitive landscape report
• Meropenem + Fosfomycin updates RSS · CI watch RSS
• National University of Singapore portfolio CI

Frequently asked questions about Meropenem + Fosfomycin

Related

• Drug class: All Combination antibiotic (carbapenem + phosphonic acid antibiotic) drugs
• Target: All drugs targeting Penicillin-binding proteins (meropenem); MurA/UDP-N-acetylglucosamine enolpyruvyl transferase (fosfomycin)
• Manufacturer: National University of Singapore — full pipeline
• Therapeutic area: All drugs in Infectious Disease
• Indication: Drugs for Multidrug-resistant gram-negative bacterial infections (including Pseudomonas aeruginosa and Acinetobacter baumannii)
• Indication: Drugs for Hospital-acquired and ventilator-associated pneumonia

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing