A Critical Evaluation of Nalidixic Acid in Urinary-Tract Infections

Ronald, Allan R.; Turck, Marvin; Petersdorf, Robert G.

doi:10.1056/nejm196611172752001

Cited by 140 publications

(53 citation statements)

References 17 publications

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“…were susceptible to nalidixic acid [8,21]. Rapid development of resistance to nalidixic acid has been reported after widespread use of the drug for urinary tract infection [5]. It is not known whether the results observed in this study are a reflection of the usage of nalidixic acid for urinary tract infections.…”

Section: Discussionmentioning

confidence: 81%

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Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Harnett¹

1992

Epidemiol. Infect.

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SUMMARYOf 1171 isolates of Escherichia coli isolated from urine samples at the Public Health Laboratory, Toronto, Ontario, Canada, between May 1990 and December 1991, 120 (10-3 %) were resistant to trimethoprim (TMP), cotrimoxazole (TMP/SMX), sulfamethoxazole (SMX) and other antimicrobial agents; 110 of the 120 isolates (91-7 %) were resistant to four or more agents. The majority of Nalidixic acid resistance was present among 22 (18-3 %) of the 120 resistant isolates, however, nalidixic acid resistance was not transferred to E. coli K-12.

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Section: Discussionmentioning

confidence: 81%

“…The introduction of newer alternative antimicrobial agents have also resulted in rapidly developing resistance which threatens the usefulness of these agents [5].…”

Section: Introductionmentioning

confidence: 99%

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Harnett¹

1992

Epidemiol. Infect.

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“…The development of resistance can significantly shorten the useful lifetime of antimicrobial agents (17,18). Resistance to nalidixic acid and new quinolones in bacteria is the result of chromosomal mutations, some of which have been identified and mapped in Escherichia coli K-12 (7,(9)(10)(11)(12).…”

mentioning

confidence: 99%

Clinical isolate of Citrobacter freundii highly resistant to new quinolones

Aoyama¹,

Fujimaki²,

Sato³

et al. 1988

Antimicrob Agents Chemother

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“…The development of bacterial resistance was studied with cinoxacin and NA. Three isolates were inoculated separately onto the surface of Mueller-Hinton agar plates containing a concentration of 4 Mg of either cinoxacin or NA per ml, or onto drug-free agar. After overnight incubation at 37 C, surface growth was swabbed onto fresh drug-containing plates (also containing 4 gug of drug per ml), or onto drug-free agar.…”

Section: Methodsmentioning

confidence: 99%

“…The first pass was onto agar plates containing 4 Ag of cinoxacin or NA per ml. After overnight incubation, surface growth was swabbed onto new agar plates containing 8 MAg of drug per ml.…”

Section: Methodsmentioning

confidence: 99%

Cinoxacin: In Vitro Antibacterial Studies of a New Synthetic Organic Acid

Lumish

Norden

1975

Antimicrob Agents Chemother

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Cinoxacin (compound 64716) is a synthetic organic acid with antibacterial activity against most aerobic gram-negative bacilli. Minimal inhibitory concentrations of cinoxacin (agar-dilution method) were determined for 419 strains. Escherichia coli was the most susceptible group of organisms. The majority of Klebsiella sp., Enterobacter sp.. Proteus sp., and Serratia marcescens were inhibited by 8 qg of cinoxacin per ml. Pseudomonas aeruginosa and all gram-positive isolates tested were resistant to 64 ,ug or less of cinoxacin per ml.Zones of inhibition using a 30-,ug disk correlated well with agar-dilution minimal inhibitory concentrations (r = -0.9). Cinoxacin was bactericidal when tested with inocula of 5 x 106 organisms per ml. Resistance to cinoxacin was readily developed in all three strains tested by serial passage on drug-containing agar. The in vitro properties of this agent were similar to those of nalidixic acid.is a synthetic organic acid with a cinnoline (1-2-benzodiazine) as its basic ring. structure. This agent, previously called compound 64716, has been shown to have antibacterial activity against gramnegative bacilli recovered from patients with urinary tract infections (7). The present study evaluated the in vitro susceptibility of different organisms to this agent and to nalidixic acid (NA), as well as the potential for development of bacterial resistance to these drugs. (MICs) of both agents were determined for a small number of isolates by the broth-dilution method. Serial twofold dilutions of drug were made in 0.5-ml volumes of Trypticase soy broth (TSB) (Baltimore Biological Laboratories) yielding final concentrations ranging from 2 to 256 Mg of drug per ml. Each tube was inoculated with 0.5 ml of either a 10-4 dilution, or a 10-2 dilution of a broth culture incubated overnight at 37 C. MICs wore determined after incubation at 37 C for 20 h. MATERIALS AND METHODS(ii) Agar-dilution method. The MICs of cinoxacin for 419 strains were determined by the agar-dilution method; 131 of these isolates were also tested with NA by the same method (2). The 131 strains selected for testing with NA were representative of the population of 419 organisms, each group having comparable geometric mean MICs of cinoxacin.Square petri dishes (100 by 15 mm) (Falcon) were each filled with 20 ml of Mueller-Hinton agar (BBL) containing, in twofold dilutions, 1 to 256 Mg of drug per ml. Drug-containing plates were stored at 4 C for up to 1 week before use. The bacterial inoculum was prepared by growing individual strains overnight in 2 ml of TSB at 37 C, with subsequent 1:100 dilution in distilled water prior to inoculation onto drug-contain-

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A Critical Evaluation of Nalidixic Acid in Urinary-Tract Infections

Cited by 140 publications

References 17 publications

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Clinical isolate of Citrobacter freundii highly resistant to new quinolones

Cinoxacin: In Vitro Antibacterial Studies of a New Synthetic Organic Acid

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