Nitrofurantoin susceptibility in bacterial pathogens causing Urinary tract infection in a tertiary care center in south India

Dr.J. Vigneshwaran; Dr. Priyadarshini Shanmugam; Janakiraman V

Volume : IX, Issue : I, January - 2020

Nitrofurantoin susceptibility in bacterial pathogens causing Urinary tract infection in a tertiary care center in south India

Dr. J. Vigneshwaran, Dr. Priyadarshini Shanmugam, Janakiraman V

Abstract :

Aims and Objectives: – To determine the percentage of Nitrofurantoin sensitive isolates among the bacteria causing Urinary Tract Infection (UTI) in a semi urban Tertiary care center in South India. Background: – Resistance to commonly prescribed antibiotics like Fluoroquinolones, Trimethoprim – Sulphamethoxazole, Aminoglycosides and oral cephalosporins is high among the uropathogens. Nitrofurantoin has emerged as a good alternative based on higher sensitivity profile, lesser adverse effects and lower cost. Materials & Methods: – This is a cross sectional study of all Urine culture positive samples, collected both as Outpatients and Inpatients in the period between 2013 and 2016 in Chettinad Hospital and Research Institute, Kelambakkam, Kanchipuram district, South India. Sensitivity profile of organisms to Nitrofurantoin and other commonly prescribed antibiotics like Fluoroquinolones, Trimethoprim – Sulphamethoxazole (TMP – SMX), second and third generation cephalosporins and aminoglycosides were analysed. Results:– Of the 664 bacterial isolates, the overall sensitivity to nitrofurantoin was found to be 80.3% {Sensitivity in Outpatient setting (OP) – 81.9%, Sensitivity in Inpatient setting (IP) – 77.2%}. The overall sensitivity to other commonly prescribed antibiotics were comparatively lesser than Nitrofurantoin – Fluroquinolone (44.5%), TMP – SMX (48.6%) , second generation cephalosporin (52.4%) , third generation Cephalosporin (57.7%) , Aminoglycoside (68.8%).Discussion: –The high sensitivity levels observed with Nitrofurantoin (80.3%) was similar to that of other studies. Escherichia coli showed a higher susceptibility to nitrofurantoin (90.8%) and 88.6% of ESBL producing E.coli isolates were nitrofurantoin susceptible. This study also reiterated that Proteus was intrinsically resistant to Nitrofurantoin. The Gram–positive organisms also displayed a higher susceptibility to nitrofurantoin. (96.4%).Conclusion: – Study findings make Nitrofurantoin an ideal choice as empirical therapy for lower UTI