Nitrofurantoin As A First-Line Agent In Uncomplicated UTIs

Main Category: Urology / Nephrology
Article Date: 09 Jun 2008 - 12:00 PDT

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ORLANDO, FL (UroToday.com) - Uncomplicated UTIs more often than not are treated with fluoroquinolones in routine clinical practice. As fluoroquinolone resistance rises, this approach to urinary infections must be re-evaluated.

Kashanian and colleagues evaluated antimicrobial susceptibility patters of urinary isolates from their institution and propose that nitrofurantoin should be used as a first line treatment for non-complicated UTIs. 95.6% of E. coli isolates were sensitive to the drug. In contrast fluoroquinolone resistance approached 25%, while 29% of cultures were resistant to TMP/SMZ.

This report should encourage urologists to consult with infectious disease specialists at their institution and determine antibiotic resistance patterns in their community. Of course, one must remember the very poor soft tissue penetration of nitrofurantoin, making this drug inappropriate for patients with acute bacterial prostatitis, pyelonephritis, or other complicated UTIs.

Presented by James Kashanian, MD, Payam Hakimian, MD, Michael L Blute, MD, Jean Wong, MD, Gilbert J Wise, MD, and Ridwan Shabsigh, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Alexander Kutikov, MD

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