[Nitrofurantoin for uncomplicated urinary tract infections in men: should it be the first choice?].

Ned Tijdschr Geneeskd

Haaglanden Medisch Centrum, afd. Interne Geneeskunde,Den Haag.

Published: October 2020

AI Article Synopsis

  • * It has benefits like low resistance levels and good tolerability, but about 27% of male patients may not be adequately treated with it.
  • * A key concern is that nitrofurantoin has low blood concentration, which may lead to insufficient treatment of infections involving prostatic tissues in men, and its safety for male patients remains uncertain.

Article Abstract

Nitrofurantoin is a commonly prescribed antibiotic for uncomplicated urinary tract infections. The Dutch College of General Practitioners guideline recommends the use of this drug for the treatment of uncomplicated urinary tract infections in both male and female patients. Treatment with nitrofurantoin has several advantages. Resistance to this antibiotic is low and does not increase in the hospitalized patient population. Treatment with nitrofurantoin is generally well-tolerated. However, two independent studies estimated that approximately 27% of male patients are undertreated with nitrofurantoin. The main downside of nitrofurantoin is the low blood concentration that leads to insufficient tissue penetration. There is little evidence on how often prostatic tissues are involved in male urinary tract infections. Unrecognized tissue involvement can lead to breakthrough urinary tract infections despite nitrofurantoin treatment. Because of this, the safety of nitrofurantoin for male patients is unknown and treatment with this antibiotic should be administered with caution.

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