A COMPARISON OF NITROFURANTOIN, FLUOROQUINOLONES AND CO-TRIMOXAZOLE SUSCEPTIBILITY PATTERN AMONG THE UROPATHOGENS IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 32
Abstract
BACKGROUND Increasing antibiotic resistance in acute uncomplicated lower urinary tract infection complicates its treatment by increasing patient morbidity and rates of hospitalisation. In the present study, we have aimed at determining the spectrum of gramnegative bacteria causing urinary tract infection; their sensitivities to nitrofurantoin, fluoroquinolones and co-trimoxazole and to compare the sensitivity pattern among different organisms and among outpatients and inpatients. MATERIALS AND METHODS We retrospectively studied the susceptibility patterns of gram-negative isolates for 2 yrs. from October 2014 to September 2016 to nitrofurantoin, fluoroquinolones and co-trimoxazole. The results were analysed statistically by χ2 test. RESULTS Out of the total of 484 gram-negative bacilli isolates from urine, 300 were E.coli, 138 were other Enterobacteriaceae and 46 were non-fermenters. Overall sensitivity among the gram-negative bacilli to nitrofurantoin was 82.6%, whereas it was 51.6% to fluoroquinolones and 42.3% to co-trimoxazole. E. coli showed 92% sensitivity rate to nitrofurantoin, 52% to fluoroquinolones and 41% to cotrimoxazole. Other Enterobacteriaceae exhibited higher sensitivity rates to nitrofurantoin (81.7%) when compared to fluoroquinolones (67.9%) and co-trimoxazole (51.1%). The non-fermenters showed higher level of sensitivity to fluoroquinolones (54.4%) than to nitrofurantoin (23.9%) and co-trimoxazole (39.1%). Among the isolates from outpatients, 91.1% were sensitive to nitrofurantoin, 80% to fluoroquinolones and 58.5% to cotrimoxazole. Isolates from the patients admitted to various wards showed higher sensitivity to nitrofurantoin (81.6%) when compared to fluoroquinolones (48.7%) and co-trimoxazole (38.8%). Isolates from the ICU patients exhibited higher level of sensitivity to nitrofurantoin (60.5%) than to fluoroquinolones (36.8%) and co-trimoxazole (28.9%). CONCLUSION This study shows that nitrofurantoin is an acceptable empirical treatment for uncomplicated UTI particularly in the outpatient setup.
Authors and Affiliations
Pavithra K, Ronald A Roche
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