Nitrofurantoin:
An Alternative Therapy for
Uncomplicated Cystitis in the Era
of Antimicrobial Resistance
964-966
Correspondence
1.MBBS, MD in Microbiology
Assistant Professor of Microbiology
K .S. Hegde Medical Academy
Karnataka, India.
Introduction : Escherichia coli have been implicated as the commonest organism causing uncomplicated cystitis. The frequent irrational use of antibiotics has led to an increased prevalence of resistance to commonly used antibiotics like cotrimoxazole, Fluoroquinolones and β-lactams. Alternative antibiotic compounds are needed to treat such infections. This study was conducted to assess the prevalence of antimicrobial resistance among Escherichia coli causing cystitis and evaluate the sensitivitity of these strains to nitrofurantoin.
Material and methods: Three hundred and thirty two strains of Escherichia coli obtained from 2293 fresh midstream urine samples were included in the study. Antibiotic sensitivity testing was done byKirby Bauer disc diffusion method according to CLSI guidelines.
Results : Seven hundred and thirty six (32.09%) cases showed significant bacteriuria. A significant number of Escherichia coli isolates were found to be resistant to ciprofloxacin (72.59%), Norfloxacin (73.49%) and cotrimoxazole (71.38%). Over 90% of the strains were sensitive to nitrofurantoin. Two hundred and seventeen isolates (65.36%) were found to be ESBL producers by phenotypic confirmatory test. The ESBL producing isolates showed a high rate of sensitivity to ertapenem (96.77%), nitrofurantoin (88.94%) and amikacin (83.41%).
Conclusion: We consider that nitrofurantoin is a good alternative antibiotic to treat uncomplicated cystitis caused by antibiotic resistant Escherichia coli.