Resurgence of nitrofurantoin in urinary tract infections

Abstract

Uncomplicated urinary tract infections (UTIs) are common, often unpleasant and, occasionally, cause serious complications. Escherichia coli causes more than three-quarters of UTIs and the HPA advocates trimethoprim or modified-release nitrofurantoin as first-line empirical treatment for uncomplicated cases. However, high levels of resistance to trimethoprim may hinder its empirical use. Despite being used for half a century, nitrofurantoin resistance does not seem to be increasing. Used as a first-line empirical treatment for uncomplicated UTIs, nitrofurantoin often produces cure rates in excess of 90% and is generally well tolerated.