Objective: To assess the efficacy and safety of oral fosfomycin trometamal in patients with urinary tract infections (UTIs) caused by multi drug resistant (MDR) bacteria in the clinical setting in China.Design and setting: Multicenter study was conducted from Jan.2011 to Dec.2011 in 12 hospitals in China.Patients with non fever UTls were treated by fosfomycin trometamal 3g once daily.The susceptibility rates of MDR bacteria to fosfomycin trometamol were caculated.The clinical efficacy, bacteriological efficacy of fosfomycin trometamol to these patients was evaluated.Results: Among the patients enrolled, 142 were included in this analysis and the safety analysis population was 356.To the gram-negative bacteria cultured, among the E.coli, Klebsiella pneumonia and proteus, 50％ (52/104) were Extended-Spectrum β-lactamases producing organisms.To the gram-positive bacteria (n=38),methicillin-resistant staphylococcus accounts for 55％ (11/20) of all the Staphylococcus and the other grampositive bacteria were Enterococcus (n=18).Higher susceptibility rates to fosfomycin trometamol were observed among MDR bacteria (85.71％) and the clinical efficacy rates and bacteriological efficacy rates of fosfomycin trometamol treatment to these patients were 96.36％ (53/55) and 87.50％ (42/48) respectively.The incidence of drug-related adverse reactions(ADRs) was 5.6％ (20 / 356).The most common ADR was diarrhea.No drugrelated serious adverse events (SAE) were found.Conclusions : The distributions of uropathogents in China were complicated.The detection rate of MDR uropathogens is really high.The dosing regimen of fosfomycin trometamal 3g once daily is effective and tolerable for the treatment of UTIs caused by MDR bacteria.It may represent good options for the empiric therapy of patients with UTIs.