Can nitrofurantoin be the first choice antimicrobial in uncomplicated urinary tract infection?
Abstract
Objective: To ascertain the in vitro sensitivity of UTI pathogens against Nitrofurantoin& other antimicrobials among the patients reporting to Fauji Foundation Hospital Rawalpindi.
Study design: Quasi experimental study.
Place & duration of study: Fauji Foundation Hospital Rawalpindi (FFH Rwp) during the period from July 2014 to December 2014.
Materials and Methods: Urine of patients of all age groups and gender attending outpatient output clinic at FFH Rwp with complaints suggestive of urinary tract infection were collected for bacteriological examination. The urine specimens were inoculated on cystein lactose electrolyte deficient agar. The sampling was done by non-probability purpose sampling. Two Hundred isolates of cultured organisms were identified using conventional tests and standard biochemical tests using API-20E (Biomerieux).
The susceptibility to antibiotics was tested using disk diffusion method with standard antimicrobial disks (Oxoid) and adopting the method of Clinical Laboratory Standard Institute (CLSI).
Results: Among the UTI pathogens isolated Escherichia coli (E.coli) was the most common (67.5%), followed by Klesbsiellapneumonae (14.5%), Pseudomonas aeruginosa, Enterococcus faecalis, Providentiaspp, Proteus mirabilis & Acinetobacterbaumannii.
Maximum susceptibility of these organisms was to imipenem. However, nitrofurantoin revealed very good effectiveness against these organisms except the organisms which are genetically resistant like Pseudomonas aeruginosa, Proteus mirabilis & Providentiastuartii. Nitrofurantion was more effective than ampicillin & Cotrimoxazole and was as effective as ciprofloxacin, Gentamicin and Cefotaxime against E.coli & Klebsiellapneumoniae.
Conclusion: Nitrofurantoin has a very good in vitro activity against common uropathogens & is recommended for empirical use and as a 1st line therapy for uncomplicated UTI.
Key words: Uncomplicated UTI, Nitrofurantoin, Oral antimicrobial.
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Copyright (c) 2016 Tariq Butt, Kamran Masud, Fatima Kaleem, Sehrish Siddique, Ruqiya Bashir, Haris Kamran, Tahir x Tahir Saleem
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