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 uro pathogens. Nitrofurantoin has emerged as a good alternative based on higher sensitivity prole, 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 prole
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 ndings make Nitrofurantoin
an ideal choice as empirical therapy for lower UTI


Keywords


Nitrofurantoin, beta lactamase, uoroquinolones, Empirical therapy, Urinary tract disease, multi drug resistance, antibiotic susceptibility

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