Comparative Sensitivity of Nitrofurantoin Versus Fluoroquinolones against E. coli Isolates from Urinary Tract Infections: A Single-centre Study

Abstract

Background and Aim: Antibiotic resistance is often seen as a potential consequence of using antimicrobial agents. This issue has been observed in cases of long-term prophylaxis for UTI and in elderly patients with renal failure. The purpose of this study was to determine the prevalence of UTI and evaluate the antibiotic sensitivity patterns. Materials and Methods: This study presents a clinic-pathological analysis conducted for urine analysis in the department of urology and other associated departments of the Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat. A total of 181 urine samples were collected from patients with UTI at GK General Hospital, from various departments, ensuring a sterile environment. The identification and Antibiotic susceptibility testing (ABST) were conducted following standard microbiological guidelines. The results were interpreted according to the guidelines set by CLSI M100 (Clinical and Laboratory Standards Institute). Results: We processed a total of 181 urine samples from various departments of the medical college. The study included 120 females and 61 males, with a ratio of 2:1. Positive growth was observed in 96 samples, which accounts for 50% of the cases. E. coli was the most frequently identified isolate, appearing in a total of 32 samples. It was followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Based on the antibiotic sensitivity testing, Nitrofurantoin demonstrated a sensitivity rate of 84.37% in E. coli isolates. However, Fluoroquinolones such as Ofloxacin, Levofloxacin, and Ciprofloxacin exhibited lower sensitivity rates of 37.5%, 31.25%, and 31.25% respectively. Conclusion: E.coli is the most common pathogen that causes UTIs. After comparing two groups of antibiotics, it was found that Nitrofurantoin is the most sensitive oral antibiotic when compared to fluoroquinolones. Because of its exceptional sensitivity, it can be used as an empirical treatment for UTI at our centre.