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Nitrofurantoin in Urinary Tract Infection: Old is Gold

Jayashree Konar, Indrani Bhattacharyya, Sipra Saha, Dipankar Paul, Sourav Maiti and Gargi Bhattacharya

Objective of the study was to find out the Resistogram of the urinary isolates against different commonly prescribed antimicrobials according to CLSI guidelines. Out of total 319 test samples, in 56 cases bacterial pathogens were isolated. Among those 56 isolates only 13 were resistant to Nitrofurantoin (23.21%) where as resistance to Ciprofloxacin was found in 40 isolates(71.42%), resistance against Co-Trimoxazole was found in 27 isolates (48.21%) and surprisingly, resistance against Carbapenem antibiotics (Meropenem) was in 20 isolates (35.71%). Majority of the Nitrofurantoin resistant bacterial isolates were Klebsiella pneumoniae (4 out of 13 i.e, 30.76%). All Nitrofurantoin resistant isolates were sensitive to both Tigecycline and Colistin and the isolated Escherichia coli (two in number) were sensitive to Meropenem also. There were no other therapeutic options like Fluroquinolones or Co-trimoxazole to manage the Nitrofurantoin resistant isolates as all of them were resistant to them. Thus medical community should think twice before replacing Nitrofurantoin with Fluroquinolones or Co-Trimoxazoles as emperical therapy.