. In the fosfomycin group, MRSA was detectable in 2 out of 10 (20%) animals (3.42 ؋ 10 2 and 1.51 ؋ 10 3 CFU/g of bone). Vancomycin was superior to the no-drug control (P ؍ 0.002), and fosfomycin was superior to the no-drug control and vancomycin (P < 0.001). The cultures from the wires were positive in all untreated animals (median, 2.5 ؋ 10 3 CFU/implant), in 10 animals in the vancomycin group (median, 1.15 ؋ 10 3 CFU/ implant), and negative in all animals in the fosfomycin group. Based on the bacterial counts from the implants, vancomycin was not superior to the no-drug control (P ؍ 0.324), and fosfomycin was superior to the no-drug control and vancomycin (P < 0.001). No emergence of resistance was observed. In conclusion, it was demonstrated that fosfomycin monotherapy is highly effective for the treatment of experimental implant-associated MRSA osteomyelitis.