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High-Performance Liquid Chromatography
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
Joel J. Kirschbaum, Adorjan Aszalos
Nitrofurantoin is used in treating infections of the urinary tract. This drug and its active 4-hydroxylation ring metabolite were determined in urine using an octadecylsilane column and a mobile phase of methanol-0.05 M phosphate buffer, pH 5 (30:70), flowing at 0.8 ml/min into a detector set to 320 nm [460]. Nitrofurantoin in plasma and urine was assayed using an octylsilane column with a mobile phase of water-ethanol (95:5) flowing at 1.6 ml/min through a detector set to 370 nm [461]. The limit of detection was 0.02 μg/ml. Recoveries averaged 92%. As little as 20 μl fluid was needed. Nitrofural, nitrofurazolidone, metronidazole, and hydroxymethylnitrifurantoin could be resolved by this LC system.
Urolithiasis
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Thomas Johnston, James Armitage, Oliver Wiseman
Penicillin, cephalosporin and macrolide antibiotics are considered safe to use in pregnancy. Nitrofurantoin is also safe for most of pregnancy but should be avoided towards term due to an increased risk of neonatal haemolysis. Trimethoprim is a folate antagonist and should be avoided, especially in the first trimester during organogenesis. There is a risk of auditory or vestibular nerve damage with gentamicin and therefore should not be used in pregnancy. There is limited information on tazocin or carbapenems with manufactures advising to use only if the potential benefit outweighs the risk in more severe infections.
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Published in Caroline Ashley, Aileen Dunleavy, John Cunningham, The Renal Drug Handbook, 2018
Caroline Ashley, Aileen Dunleavy, John Cunningham
Advice from MHRA advises to avoid nitrofurantoin if GFR<60 mL/min due to risk of treatment failure as the drug is ineffective due to inadequate urine concentration. (MHRA. Drug Safety Update.Nitrofurantoin: reminder on precautions for use, especially renal impairment in (elderly) patients. August 2013; 7(1).)
Closure of a large myelomeningocele defect using the V–Y rotation advancement flap (butterfly flap): a case report and literature review
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Hatan Mortada, Tareg Alhablany, Tanveer A. Bhat, Abdulla Al Tamimi
A 5-day-old male neonate was delivered at 35 weeks of gestation via cesarean section at our institute, King Saud Medical City in Riyadh, Saudi Arabia, who had several congenital defects involving skeletal dysplasia, hydrocephalus, meningoencephalocele, and thoracolumbar MMC at the T6–L2 level (Figure 1). Because of respiratory distress in the postnatal period, the infant was on invasive mechanical ventilation in neonatal intensive care unit (NICU) settings. During evaluation, the patient weighed 2.9 kg with a head circumference of 28.5 cm and Apgar score of 9/9. The baby had hemiplegia. There were two MMCs, one non-ruptured in the cervical region of size 8 × 8 cm2, and the other in the thoracolumbar area of size 12 × 16 cm2 ruptured with a ratio of its maximum width to that of back >0.5, with a leaking CSF. Moreover, the thoracolumbar spine was kyphotic. No urogenital abnormalities were observed. In the prenatal period, the baby’s mother had two previous miscarriage histories of unidentified causes and recurrent episodes of lower urinary tract infections treated with nitrofurantoin during pregnancy. Signed consent to use preoperative and postoperative images for publication was obtained from the parents.
Long-term effects of antimicrobial drugs on the composition of the human gut microbiota
Published in Gut Microbes, 2020
M. Mulder, D. Radjabzadeh, J. C. Kiefte-de Jong, A. G. Uitterlinden, R. Kraaij, B. H. Stricker, A. Verbon
Beta-lactam antibiotics caused a lower diversity and differences in community structure in the first year after use. Beta-lactams have been associated with effects on the composition of the gut microbiota in several small studies.17 Use of tetracyclines has been associated with a relative increase in the abundance of Bacteroidetes.27 Doxycycline use was shown to be associated with a lower diversity and a relative increase of Bacteroidetes in mice.28 Nitrofurantoin was shown to have only minor effects in a study in patients with urinary tract infections.29 These studies, however, investigated the effects after a maximum of a few months. Since we did not find any effects in our longer time periods, this might suggest that the effects of these antimicrobial drugs on the gut microbiota are restored after a few months. We also did not find any effects for sulfonamides and trimethoprim, but the use of these drugs (singly or in combination products) was very low.
Different antibiotic regimes in men diagnosed with lower urinary tract infection – a retrospective register-based study
Published in Scandinavian Journal of Primary Health Care, 2020
Helena Kornfält Isberg, Katarina Hedin, Eva Melander, Sigvard Mölstad, Olof Cronberg, Sven Engström, Heidi Lindbäck, Thomas Neumark, Gunilla Stridh Ekman, Anders Beckman
The recommended treatment duration for the first-line antibiotics in lower UTI in men (pivmecillinam or nitrofurantoin) is seven days. In our study, median treatment duration for nitrofurantoin was five days, and for pivmecillinam, it was seven days. This indicates that treatment duration differs from treatment guidelines. The minimum duration of antibiotic treatment for lower UTI in men has not yet been determined [3] but a recent Danish retrospective study showed no significant difference in treatment failure between five- or seven-day regimens with pivmecillinam in men [21]. In a review article, the researchers could only identify one RCT [22] and one observational study [23] since the year 2000 addressing male UTI [24]. Concluding these studies, duration of therapy for acute UTI in men should be limited to seven to 14 days [24].