Nitrofurantoin and Fosfomycin Susceptibility Among Outpatient Uropathogens in a Tertiary Care Center in Southern Thailand

Objective: To document susceptibility to fosfomycin and nitrofurantoin among uropathogens isolated from the Out Patient Department and Emergency Room of Songklanagarind Hospital.Material and Methods: From October 2011 to May 2012, bacteria isolated from urine specimens of outpatients with pyuria were evaluated for susceptibility to nitrofurantoin and fosfomycin. The medical records of the patients were reviewed for uropathogens and other antimicrobial susceptibilities. The urinary tract infections (UTIs) were classified into complicated and uncomplicated. Factors associated with fosfomycin and nitrofurantoin susceptibilities were also studied.Results: The study included 324 patients with positive urine cultures. Complicated UTIs and uncomplicated UTIs were found in 72.8% and 27.2%, respectively. The most common causative uropathogen was Escherichia coli (E. coli) (71.9%) followed by Klebsiella pneumoniae (16.7%). The susceptibility of E. coli to fosfomycin was 98.7%, and the susceptibilities of E. coli, K. pneumoniae, and overall pathogens to nitrofurantoin were 91.0%, 24.1% and 74.1% respectively. Conclusion: The uropathogens in Songklanagarind Hospital have higher susceptibilities to fosfomycin than to nitrofurantoin.