Effect of Norfloxacin, Trimethoprim-Sulfamethoxazole and Nitrofurantoin on Fecal Flora of Women with Recurrent Urinary Tract Infections

Mavromanolakis, E.; Maraki, Sofia; Samonis, George; Tselentis, Yannis; Cranidis, Angelos

doi:10.1179/joc.1997.9.3.203

Cited by 43 publications

(24 citation statements)

References 10 publications

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“…For instance, circulation of plasmids is very limited 39 , chromosomal mutants are dwarfed in the expression of virulence traits, unable to spread and induce further infections, and cross resistance with other classes of drugs is unknown 13,40 . In addition, the drug exerts minimal negative influence on the intestinal microflora, similarly to nitrofurantoin 41 , and is not incorporated in animal feed 42 .…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Patterns of Contemporary Pathogens from Uncomplicated Urinary Tract Infections Isolated in a Multicenter Italian Survey: Possible Impact on Guidelines

Fadda¹,

Nicoletti²,

Schito³

et al. 2005

Journal of Chemotherapy

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During 2004 four Italian Laboratories assessed the prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in female out-patients. A total of 600 urine samples from individuals aged 18-65 were studied. The overall prevalence of Escherichia coli was 85.3%. Klebsiella pneumoniae, Staphylococcus saprophyticus, Proteus mirabilis, Enterococcus faecalis and other rarer species were far less represented. Determination of the antibiotic susceptibility pattern of the entire collection of E. coli (512 organisms) revealed that among the drugs analyzed ampicillin was the least active molecule with only 62.5% of the strains being inhibited. Amoxicillin-clavulanate and cefuroxime displayed a higher potency (87.7% and 89.2% respectively). Cotrimoxazole inhibited only 70.1% of the uropathogens. The three fluoquinolones tested had comparable activity ranging from 83.0% for ciprofloxacin, to 83.6% for levofloxacin and 84.9% for prulifloxacin, indicating an identical spectrum of cross resistance. Nitrofurantoin (96.7%) and fosfomycin (98.6%) were the most potent drugs. Against the whole collection of uropathogens, only cefuroxime, nitrofurantoin and fosfomycin overcame the threshold of 90% activity, with the fluoroquinolones and amoxicillin-clavulanate suffering from about 15% resistance. The results of this survey strongly support the conclusions of recent Italian guidelines concerning the best empiric treatment of UTI in this country today.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Susceptibility Patterns of Contemporary Pathogens from Uncomplicated Urinary Tract Infections Isolated in a Multicenter Italian Survey: Possible Impact on Guidelines

Fadda¹,

Nicoletti²,

Schito³

et al. 2005

Journal of Chemotherapy

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“…The common finding in our patient, the in vitro experiments and the clinical trials, is the significant reduction in the levels of E. coli [2,5,8]. The E. coli population was resistant to quinolones but no extended spectrum resistance to β-lactams, especially cephalosporins, was detected.…”

Section: Discussionmentioning

confidence: 80%

“…It seems that aside from norfloxacin, quinolones have produced a minor effect on them [2,8,9]. The overgrowth of resistant bacteria has not generally been seen [9], nor has susceptibility to ciprofloxacin for E. coli and enterococci been universal [2].…”

Section: Discussionmentioning

confidence: 99%

Impact of prolonged treatment with high-dose ciprofloxacin on human gut flora: a case report

et al. 2010

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IntroductionCiprofloxacin is a commonly marketed fluoroquinolone. It is not effective against obligate anaerobes, hence it is considered unlikely to have an impact on colonic microflora. We report the case of a patient who received prolonged treatment with high-dose ciprofloxacin for extensive pelvic osteomyelitis. We also report on the medication's effects on his bowel flora. To the best of our knowledge, this is the first report discussing the effects of prolonged administration of a quinolone on microbial flora.Case presentationA 62-year-old Caucasian man with diabetes presented with low back pain of four months' duration. A magnetic resonance imaging of his pelvis revealed sacroiliitis and extensive pelvic osteomyelitis. Pseudomonas aeruginosa, which is susceptible to ciprofloxacin, was noted as the offending pathogen. After seven weeks of intravenous treatment, he was prescribed with high-dose oral ciprofloxacin that he continued to take for the next 20 months. Quantitative stool cultures of our patient were obtained a month later as well as at the end of his treatment to record his corresponding sensitivities to the medication. The Gram-negative population of his bowel flora was restored fully upon the discontinuation of this medication. The Gram-negative population was shown to be fully sensitive to ciprofloxacin. His yeast levels were also found to be slightly increased, and no growth of resistant enterococci was noted.ConclusionThe findings of this case report suggest that long term and high dose ciprofloxacin administration might be safe in preventing the risk of colonization with resistant Gram negative pathogens, overgrowth of anaerobes and the development of resistant enterococci.

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“…Antimicrobials that have been studied for prophylaxis include trimethoprim, TMP-SMX, norfloxacin, and nitrofurantoin. Mauromanolakis et al [27] conducted a small study of prophylaxis with these agents for 1 month. Quantitative aerobic cultures of fecal samples from women receiving prophylactic therapy were performed at 2 and 4 weeks after the initiation of therapy and 2 weeks after discontinuation of therapy.…”

Section: Recurrent Urinary Tract Infectionmentioning

confidence: 98%

Antibiotic selection for urinary tract infection: New microbiologic considerations

Brown

1999

Curr Infect Dis Rep

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Urinary tract infection (UTI) is an extremely common clinical condition, especially among women, half of whom will have at least one episode of acute cystitis at some point during adult life. An estimated one quarter of these women will have frequent, recurrent UTI. The microbiology of uncomplicated UTI is very predictable, with the vast majority of cases attributed to Escherichia coli. Recent reports from the United States and Europe have shown that resistance among uropathogens to agents that have traditionally been recommended as firstline therapy for uncomplicated UTI is on the rise. Although resistance to fluoroquinolone antibiotics among community-acquired uropathogens remains very low in the United States, fluoroquinolone resistance in community-acquired UTI isolates from other parts of the world has been increasingly described. Very low levels of resistance to nitrofurantoin among uropathogens has revived interest in this agent. The effect of in vitro resistance in uropathogens on the clinical response to treatment of acute cystitis is not well studied. The implications of emerging resistance among the causative agents of this extremely common infection for therapy of UTI are discussed.

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Effect of Norfloxacin, Trimethoprim-Sulfamethoxazole and Nitrofurantoin on Fecal Flora of Women with Recurrent Urinary Tract Infections

Cited by 43 publications

References 10 publications

Antimicrobial Susceptibility Patterns of Contemporary Pathogens from Uncomplicated Urinary Tract Infections Isolated in a Multicenter Italian Survey: Possible Impact on Guidelines

Antimicrobial Susceptibility Patterns of Contemporary Pathogens from Uncomplicated Urinary Tract Infections Isolated in a Multicenter Italian Survey: Possible Impact on Guidelines

Impact of prolonged treatment with high-dose ciprofloxacin on human gut flora: a case report

Antibiotic selection for urinary tract infection: New microbiologic considerations

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