Comprehensive assessment of nitrofurans for lower urinary tract infections | CMAC

Comprehensive assessment of nitrofurans for lower urinary tract infections

Clinical Microbiology and Antimicrobial Chemotherapy. 2025; 27(1):4-10

​ Kozlov R.S., Golub A.V.
10.36488/cmac.2025.1.4-10
uncomplicated urinary tract infections acute cystitis antimicrobials antimicrobial chemotherapy nitrofurans nitrofurantoin furazidine
Section
Diseases and Pathogens
Type
Review
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2025; 27(1):4-10

Abstract

Antimicrobial therapy is an essential part of treatment of urinary tract infections, often being the only etiological and pathogenetic component of it. At the same time, the rationality of choosing an antimicrobial depends both on the sensitivity of the main causative pathogens and on the their pharmacokinetic and pharmacodynamic characteristics. The article provides data on the quarter-century monitoring of the etiology and antimicrobial susceptibility of uropathogens in Russia, substantiates recommendations for the choice of nitrofurans for uncomplicated acute cystitis.

Roman S. Kozlov

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

Alexey V. Golub

Institute of Antimicrobial Chemotherapy, Smolensk, Russia

  • 1. European Association of Urology. Guidelines on urological infections. Available at: www.uroweb.org. Accessed March 2025.
  • 2. Hooton T.M., Scholes D., Hughes J.P, Winter C., Roberts P.L., Stapleton A.E., et al. A prospective study of risk factors for symptomatic urinary tract infections in young women. N Engl J Med. 1996;335(7):468-474. DOI: 10.1056/NEJM199608153350703
  • 3. Loran O.B. Urinary tract infections in outpatient patients. Materials of the symposium. 1999. 5-9 p. Russian.
  • 4. Foxman B., Barlow R., D’Arcy H., Gillespie B., Sobel J.D. Urinary tract infection: self-reported incidence and associated cost. Ann Epidemiol. 2000;10(8):509-515. DOI: 10.1016/s1047-2797(00)00072-7
  • 5. Zhanel G.G., Hisanaga T.L., Laing N.M., DeCorby M.R., Nichol K.A., Palatnik L.P., and NAUTICA Group. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int J Antimicrob Agents. 2005;26(5):380-388. DOI: 10.1016/j.ijantimicag.2005.08.003
  • 6. Schito G.C., Naber K.G., Botto H., Palou J., Mazzei T., Gualco L., et al. The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections. Int J Antimicrob Agents. 2009;34(5):407-413. DOI: 10.1016/j.ijantimicag.2009.04.012
  • 7. Lopatkin N.A., Stratchounsky L.S., Rafalsky V.V., Derevyanko I.I., Kretchikova O.I., Edelshtein I.A., et al. The choice of antimicrobial drugs for uncomplicated urinary tract infections of community-acquired origin. Guidelines for practitioners. Smolensk; 2002. 14 p. Russian.
  • 8. Multicenter study of resistance of ambulatory pathogens of ambulatory urinary tract infections (UTIAP-3). Scientific report of the Institute of Antimicrobial Chemotherapy. Smolensk; 2006. Russian.
  • 9. Mazzulli T. Resistance trends in urinary tract pathogens and impact on management. J Urol. 2002;168(4 Pt. 2):1720-1722. DOI: 10.1097/01.ju.0000028385.10311.c9
  • 10. Hooton T.M. Fluoroquinolones and resistance in the treatment of uncomplicated urinary tract infection. Int J Antimicrob Agents. 2003;22(Suppl. 2):65-72. DOI: 10.1016/s0924-8579(03)00238-3
  • 11. Katsarolis I., Poulakou G., Athanasia S., Kourea-Kremastinou J., Lambri N., Karaiskos E., et al. Acute uncomplicated cystitis: from surveillance data to a rationale for empirical treatment. Int J Antimicrob Agents. 2010;35(1):62-67. DOI: 10.1016/j.ijantimicag.2009.08.018
  • 12. Palagin I.S., Sukhorukova M.V., Dekhnich A.V., Edelstein M.V., Shevelev A.N., Grinyov A.V., Perepanova T.S., Kozlov R.S., «DARMIS» Study Group. The current state of antibiotic resistance of community-acquired urinary tract infections in Russia: the results of the DARMIS study (2010-2011). Kliniceskaa mikrobiologia i antimikrobnaa himioterapia. 2012;14(4):280-302. Russian.
  • 13. Palagin I.S., Sukhorukova M.V., Dekhnich A.V., Edelstein M.V., Perepanova T.S., Kozlov R.S. and “DARMIS-2018” Study Group. Antibiotic resistance of pathogens of community-acquired urinary tract infections in Russia: results of the multicenter study «DARMIS-2018». Kliniceskaa mikrobiologia i antimikrobnaa himioterapia. 2019;21(2):134-146. Russian. DOI: 10.36488/cmac.2019.2.134-146
  • 14. Kozlov R.S., Palagin I.S., Ivanchik N.V., Trushin I.V., Dekhnich A.V., Edelstein M.V., Perepanova T.S., and “DARMIS-2023” Study Group. National monitoring of antibiotic resistance of community-acquired urinary tract infections in Russia: results of the multicenter epidemiological study «DARMIS-2023». Kliniceskaa mikrobiologia i antimikrobnaa himioterapia. 2024;26(3): 328-337. Russian. DOI: 10.36488/cmac.2024.3.328-337
  • 15. Bljuger A.F. Nitrofurans and their use in medicine. Riga: Izdatel’stvo Akademii nauk latvijskoj SSR; 1958. 180 p. Russian.
  • 16. Padejskaja E.N. Synthetic antibacterial drugs. The results of science. Pharmacology, toxicology, problems of chemotherapy. М; 1967. 7-54 p. Russian.
  • 17. Giller S.A. Life and scientific activity. Riga: Zinatne; 1982. 392 p. Russian.
  • 18. Perepanova T.S., Kozlov R.S., Rudnov V.A., Sinjakova L.A. Federal clinical recommendations. Antimicrobial therapy and prevention of infections of the kidneys, urinary tract and male genital organs. M; 2015. 72 p. Russian.
  • 19. Perepanova T.S., Kozlov R.S., Rudnov V.A., Sinjakova L.A., Palagin I.S. Federal clinical recommendations. Antimicrobial therapy and prevention of infections of the kidneys, urinary tract and male genital organs. M; 2022. 126 p. Russian.
  • 20. Rossijskoe obshhestvo urologov. Clinical recommendations. Cystitis in women. 2024. 40 р. Russian.
  • 21. Ramenskaya G.V. The study of comparative pharmacokinetics of Furamag and Furagin. Infections and antimicrobial therapy. 2004. 2 p. Russian.
  • 22. Padejskaja E.N. Furamag among antimicrobial drugs derived from 5-nitrofuran: implications for clinical practice. Infections and antimicrobial therapy. 2004. 8 p. Russian.
  • 23. Sidrenko S.V., Ivanov D.V. The results of the study of the spread of antibiotic resistance of pathogens of communityacquired urinary tract infections in Moscow. Phase I. Antibiotics and chemotherapy. 2005. 8 p. Russian.
  • 24. Bielec F., Brauncajs M., Pastuszak-Lewandoska D. Nitrofuran derivatives cross-resistance evidence – uropathogenic Escherichia coli nitrofurantoin and furazidin in vitro susceptibility testing. J Clin Med. 2023;12(16):5166. DOI: 10.3390/jcm12165166
  • 25. Van Pienbroek E., Hermans J., Kaptein A.A., Mulder J.D. Fosfomycin trometamol in a single dose versus seven days nitrofurantoin in the treatment of acute uncomplicated urinary tract infections in women. Pharm World Sci. 1993;17;15(6):257-262. DOI: 10.1007/BF01871127
  • 26. Sander J., Aandahl E., Fellner H., Kalstad S. The treatment of urinary tract infections in out-patients. A double-blind comparison between trimethoprim and nitrofurantoin. J Int Med Res. 1981;9(3):181-185. DOI: 10.1177/030006058100900305
  • 27. Spencer R.C., Moseley D.J., Greensmith M.J. Nitrofurantoin modified release versus trimethoprim or co-trimoxasole in the treatment of uncomplicated urinary tract infection in general practice. J Antimicrob Chemother. 1994;33(Suppl. A):121-129. DOI: 10.1093/jac/33.suppl_a.121
  • 28. Stein G.E. Comparison of single-dose fosfomycin and a 7-day course of nitrofurantoin in female patients with uncomplicated urinary tract infection. Clin Ther. 1999;21(11):1864-1872. DOI: 10.1016/S0149-2918(00)86734-X
  • 29. Lohr J.A., Hayden G.F., Kesler R.W., Gleason C.H., Wood J.B., Ford R.F., et al. Three-day therapy of lower urinary tract infection with nitrofurantoin macrocrystals: a randomized clinical trial. J Pediatr. 1981;99(6):980-983. DOI: 10.1016/s0022-3476(81)80037-6
  • 30. Christiaens T.C.M., De Meyere M., Verschraegen G., Peersman W., Heytens S., De Maeseneer J.M. Randomized controlled trial of nitrofurantoin versus placebo in the treatment of uncomplicated urinary tract infection in adult women. Br J Gen Pract. 2002;52(482):729-734. DOI: 10.1093/oxfordjournals.aje.a010170
  • 31. Iravani A., Klimberg I., Briefer C., Munera C., Kowalsky S.F., Echols R.M. A trial comparing low-dose, shortcourse ciprofloxacin and standard 7 day therapy with co-trimoxazole or nitrofurantoin in the treatment of uncomplicated urinary tract infection. J Antimicrob Chemother. 1999;43(Suppl. A):67-75. DOI: 10.1093/jac/43.suppl_1.67
  • 32. Dybowski B., Jablonska O., Radziszewski P., GromadzkaOstrowska J., Borkowski A. Ciprofloxacin and furagin in acute cystitis: comparison of early immune and microbiological results. Int J Antimicrob Agents. 2008;31(2):130-134. DOI: 10.1016/j.ijantimicag.2007.08.021
  • 33. Jakovlev S.V., Logvinov L.A., Klochkov I.A. Clinical and bacteriological efficacy of Furamag in patients with acute cystitis. Infections and antimicrobial therapy. 2005;7:120-126. Russian.
  • 34. Sanford J.P. Urinary tract symptoms and infection. Annu Rev Med. 1975;26:485-498. DOI: 10.1146/annurev.me.26.020175.002413
  • 35. Muller A.E., Verhaegh E.M., Harbarth S., Mouton J.W., Huttner A. Nitrofurantoin’s efficacy and safety as prophylaxis for urinary tract infections: a systematic review of the literature and meta-analysis of controlled trials. Clin Microbiol Infect. 2017;23(6):355-362. DOI: 10.1016/j.cmi.2016.08.003
  • 36. Butler C.C., Dunstan F., Heginbothom M., Mason B., Roberts Z., Hillier S., et al. Containing antibiotic resistance: decreased antibiotic-resistant coliform urinary tract infections with reduction in antibiotic prescribing by general practices. Br J Gen Pract. 2007;57(543):785-792. PMID: 17925135.
  • 37. Brumfitt W., Hamilton-Miller J.M. Efficacy and safety profile of long-term nitrofurantoin in urinary tract infections: 18 years’ experience. J Antimicrob Chemother. 1998;42(3):363-371. DOI: 10.1093/jac/42.3.363
  • 38. Karpman E., Kurzrock E.A. Adverse reactions of nitrofurantoin, trimethoprim and sulfamethoxazole in children. J Urol. 2004;172(2):448-453. DOI: 10.1097/01.ju.0000130653.74548.d6
  • 39. Krantz J.C., Evans W.E. A contribution to the pharmacology of 5-nitro-2-furaldehyde semicarbazone. J Pharmacol Exp Therap. 1945;85:324-331. DOI: 10.1016/s0022-3565(25)07989-3
  • 40. Miyaji T. Acute and chronic toxicity of furylfuramide in rats and mice. Tohoku J Exp Med. 1971;103(4):331-369. DOI: 10.1620/tjem.103.331
  • 41. Kozlov R.S., Golub A.V. To stop the progress of antimicrobial resistance today means to give a chance of mankind surviving tomorrow. Kliniceskaa mikrobiologia i antimikrobnaa himioterapia. 2019;4:310-315. Russian. DOI: 10.36488/cmac.2019.4.310-315
Views
0 Abstract
0 PDF
0 Crossref citations
Shared