This is a general recommendation applicable to all neuropathic pain syndromes except for trigeminal neuralgia.In regard to the specific diagnoses, the best evidence exists for gabapentin treatment of postherpetic neuralgia and diabetic neuropathy. Gabapentin is approved for the former indication in the US. In addition to these two neuropathies, European Federation of Neurological Societies guideline notes gabapentin effectiveness for central pain. A combination of gabapentin with an opioid or nortriptyline may work better than either drug alone.Overall, gabapentin shows moderate effectiveness for neuropathic pain. Only a minority of patients obtain meaningful relief. Out of 10 persons treated with gabapentin, three to four benefit substantially as compared to one to two persons treated with placebo.Evidence finds little or no benefit and significant risk in those with chronic low back pain or sciatica. Gabapentin is not effective in HIV-associated sensory neuropathy and neuropathic pain due to cancer. Anxiety
There is a small amount research on the use of gabapentin for the treatment of anxiety disorders. In a controlled trial of breast cancer survivors with anxiety, and in a trial for social phobia, gabapentin significantly reduced anxiety levels. For panic disorder, gabapentin is ineffective. Conversely, some psychiatric textbooks see "a possible role for gabapentin in anxiety disorders, particularly social phobia and panic disorder" based on "case reports and double-blind studies" or state that controlled studies have not shown gabapentin to be very effective for psychiatric indications; "however, clinically it is effective". Sleep
Gabapentin is effective in treating sleep disorders such as insomnia and restless legs syndrome.
Fosfomycin, sold under the brand name Monurol among others, is an antibiotic primarily used to treat lower UTI. It is not indicated for kidney infections. Occasionally it is used for prostate infections. It is generally taken by mouth.Common side effects include diarrhea, nausea, headache, and vaginal yeast infections. Severe side effects may include anaphylaxis and Clostridium difficile-associated diarrhea. While use during pregnancy has not been found to be harmful, such use is not recommended. A single dose when breastfeeding appears safe. Fosfomycin works by interfering with the production of the bacterial cell wall.Fosfomycin was discovered in 1969 and approved for medical use in the United States in 1996. It is on the World Health Organizations List of Essential Medicines. The World Health Organization classifies fosfomycin as critically important for human medicine. It is available as a generic medication. It was originally produced by certain types of Streptomyces, although it is now made chemically. Medical uses
Fosfomycin is used to treat bladder infections, where it is usually given as a single dose by mouth.Oral fosfomycin is not recommended for children under 12 years old.Additional uses have been proposed. The global problem of advancing antimicrobial resistance has led to a renewed interest in its use more recently.Fosfomycin can be used as an efficacious treatment for both UTIs and complicated UTIs including acute pyelonephritis.