C/19. Nitrofurantoin. Phosphomycine. Pharmacotherapy of urinary tract infections. Flashcards
Drugs need to know in this topic
Nitrofurantoin, Fosfomycin
Nitrofurantoin
Classified as urinary antiseptic
lacks systemic antibacterial effects
Active against many urinary tract pathogens (not Proteus and Pseudomonas)
Used in the treatment of uncomplicated lower UTI’s
Oral
Urine acidification enhances the drug activity
Rapid renal elimination
when uses prolong GI distress Skin rash Pulmonary infiltrate Phototoxicity Acute hemolysis in G6PD deficient patients
Fosfomycin
Inhibits the bacterial enzyme enolpyruvate transferase->blocking synthesis of N-acetylglucosamine (precursor of bacterial cell wall synthesis)
Bactericidal effect
Gram-positive and -negative
Used in the treatment of
uncomplicated lower UTI’s in
women (oral, single dose)
Oral, parenteral
Renal elimination; excreted unchanged
GI distress (diarrhea)
Pharmacotherapy of urinary tract infections.
Uncomplicated UTI Acute cystitis in women; Nitrofurantoin PO and TMP-SMX PO Acute prostatitis in men; TMP-SMX PO or Ciprofloxacin PO
Pyelonephritis; Ciprofloxacin PO/IV
TMP-SMX PO/IV
Pelvic inflammatory disease (PID); Clindamycin IV and Gentamycin PO