Nitrofurantoin as a preferred first-line therapy for urinary tract infection: A comparison using urinary tract infection-specific antibiograms
Background: Local antibiograms are a highly useful tool to guide empiric antibiotic therapy for a variety of infections. Objectives: This study compares nitrofurantoin (NF) susceptibility in outpatient urine isolates using antibiogram data from two United States academic medical centers. Methods: In this brief report, we compare antibiograms of urinary isolates from two distinct academic institutions—the University of Texas Southwestern (UTSW) in Dallas, Texas, and the University of Kansas Medical Center (KU) in Kansas City, Kansas—focusing on the most common uropathogens susceptible to NF to evaluate whether NF remains an appropriate first-line agent for uncomplicated cystitis. Results: For the 2022 antibiogram, KU tested 5,524 urinary isolates and UTSW tested 2,530 urinary isolates. The susceptibility data were consistent across the two institutions, suggesting that NF can continue to be considered a first-line therapy for uncomplicated urinary tract infections in women. Conclusion: This report highlights the importance of clinicians consulting their local antibiograms to inform empiric antibiotic therapy.
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