Abstract
Background Nitrofurantoin is a preferred choice of antibiotic for treating urinary tract infections UTIs caused by vancomycin-sensitive and vancomycin-resistant strains including cases associated with catheter use. Recently there has been an emergence of resistance among Enterobacteriaceae Gram negative bacteria and this indicates extensively drug resistant XDR phenotype that makes the treatment of uncomplicated UTI difficult.Methods Clean catch midstream urine sample was collected from adults after providing instructions about the method of sample collection. Catheter specimen was collected in non-ambulatory patients. Collection of sample from urine bag was strictly avoided. The samples were transported at the earliest to the laboratory and subjected to processing as per the standard operative procedure for processing urine specimen. Microscopy semi-quantitative culture of the colonies species identification and antibiotic susceptibility tests of the organisms isolated were performed. Special reference to nitrofurantoin susceptibility was noted.Results Out of the 50 samples collected from patients who reported with the symptoms of UTI 78 exhibited growth while 22 showed no growth. Escherichia coli was the most frequently isolated organism followed by Klebsiella pneumoniae Pseudomonas species. Nitrofurantoin resistance was the highest in Acinetobacter sp.Conclusion Nitrofurantoin drug is commonly prescribed in uncomplicated UTIs and is frequently used in the treatment of multi drug resistant infections. It is very important to identify urinary tract pathogens up to species level. This avoids prescription of Nitrofurantoin in cases where organisms with increasing resistance have been identified.
Published Version
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