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Background: Urinary tract infection (UTI) is considered one of the most common infections occurring in different ages. The increasing emergence and rapid spread of multidrug-resistant (MDR) pathogens has led to reuse older antimicrobials like Fosfomycin. This study aimed to evaluate the activity of Fosfomycin on MDR pathogens beside its effect on biofilm formation. Methods: A total of 116 MDR Gram -negative isolates from ICU patients suffering from UTI has been included in this study. Standard microbiological tests were done to identify the isolates. Susceptibility to various antibiotics was detected by disk diffusion method. Phenotypic tests for determining various β-lactamases were done. Minimal inhibitory concentration (MIC) for Fosfomycin was detected by agar dilution method. Formation of biofilm by the isolates with and without adding Fosfomycin was assessed by microtiter plate method. Results: The most frequently isolated pathogen was E. coli (70/116); 60.3% followed by Klebsiella spp. (31/116); 26.7%. Fosfomycin showed a high level of inhibitory effect on most of tested isolates ; E. coli revealed low resistance rate of 4.2%, while Klebsiella spp, Pseudomonas aeruginosa and Acinetobacter baumani showed resistance rate of 16% ,36%), and 50%, respectively. A total of 72 (62.1%) isolates was ESBL producers, of which 92% isolates were Fosfomycin -sensitive , while 25(22%) isolates were MBL-positive, of which 88% were sensitive to Fosfomycin. Eighty-seven (75%) isolates were biofilm producers. Fosfomycin inhibited biofilm formation in 67(77%) isolates. Conclusion: ESBL and MBL producing Gram negative urinary pathogens showed high sensitivity level to Fosfomycin. Also, Fosfomycin had good inhibitory effect on their biofilm formation.

| Cisplatin is a potent, first-line chemotherapeutic drug used for a variety of solid tumors in pet animals as well as humans. The therapeutic application of cisplatin is restricted due to its resistance and toxicity to the healthy tissues. In addition, it exhibits less selectivity for tumor against normal tissue that may be a crucial limiting element for its worth. To handle these limitations of the free drug, nanotechnology-based therapeutics have shown clear benefits compared to unmodified drugs, including better half-life, survival, performance targeting and less side effects for patients. Nanoparticle drug delivery systems have been investigated to facilitate the delivery of cisplatin to kill cancer cells. Nanoparticles/drug conjugate design has important effects on pharmacokinetics, bio-distribution of the drug which reduces its observed toxicity. Formulations that allow enhanced delivery and controlled release of anti-tumor drug can actually accomplish the goal of nanomedicine as a means of enhancing effectiveness and minimal serious side effects. Here, we survey some of the most common adverse effects associated with cisplatin conventional therapy with highlights latest progress in formulations of nanoparticles; concentrating on the promising agents in preclinical or clinical studies; as smart nanocarriers conjugate that composed of metal nanoparticles as a delivery vehicle for cisplatin to target the tumor mass and reduce its side effects and tissue toxicity.