Nitroxoline: an option for the treatment of urinary tract infection with multi-resistant uropathogenic bacteria

Hof, Herbert; Juretschke, C.

doi:10.1007/s15010-018-1253-y

Cited by 9 publications

(10 citation statements)

References 16 publications

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“…It has recently been reported that, in a particular case, nitroxoline was the only drug fully active against two different MDR uropathogens found in the same patient [43]. In the annual survey of laboratory results presented in this study, we confirm that nitroxoline remains active against many uropathogens, which are otherwise resistant to the commonly used antibiotics (Figure 2).…”

Section: Co-localisation Of Transferable Resistance To Cotrimoxazole Esbl and Quinolonessupporting

confidence: 82%

Compared with Cotrimoxazole Nitroxoline Seems to Be a Better Option for the Treatment and Prophylaxis of Urinary Tract Infections Caused by Multidrug-Resistant Uropathogens: An In Vitro Study

et al. 2021

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The resistance of uropathogens to various antibiotics is increasing, but nitroxoline remains active in vitro against some relevant multidrug resistant uropathogenic bacteria. E. coli strains, which are among the most common uropathogens, are unanimously susceptible. Thus, nitroxoline is an option for the therapy of urinary tract infections caused by multiresistant bacteria. Since nitroxoline is active against bacteria in biofilms, it will also be effective in patients with indwelling catheters or foreign bodies in the urinary tract. Cotrimoxazole, on the other hand, which, in principle, can also act on bacteria in biofilms, is frequently inactive against multiresistant uropathogens. Based on phenotypic resistance data from a large number of urine isolates, structural characterisation of an MDR plasmid of a recent ST131 uropathogenic E. coli isolate, and publicly available genomic data of resistant enterobacteria, we show that nitroxoline could be used instead of cotrimoxazole for intervention against MDR uropathogens. Particularly in uropathogenic E. coli, but also in other enterobacterial uropathogens, the frequent parallel resistance to different antibiotics due to the accumulation of multiple antibiotic resistance determinants on mobile genetic elements argues for greater consideration of nitroxoline in the treatment of uncomplicated urinary tract infections.

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Section: Co-localisation Of Transferable Resistance To Cotrimoxazole Esbl and Quinolonessupporting

confidence: 82%

Compared with Cotrimoxazole Nitroxoline Seems to Be a Better Option for the Treatment and Prophylaxis of Urinary Tract Infections Caused by Multidrug-Resistant Uropathogens: An In Vitro Study

et al. 2021

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“…Afterward, the resulting cells were seeded on blood agar plates for counting a) After exposure of B. henselae stationary phase to nitroxoline, 6% viable cells remained b) The MIC in the range 0.31–0.63 µg/mL confirms that nitroxoline has high potency against B. henselae Valentine-King et al ( 2019 ) Ureaplasma parvum Ureaplasma urealyticum Mycoplasma hominis Mycoplasma pneumoniae Mycoplasma genitalium a) The MIC for nitroxoline and the other test compounds were determined against the bacterial species previously mentioned, using the broth microdilution method and the agar dilution method b) Similarly, the minimum bactericidal concentration (MBC) was evaluated for nitroxoline and other test compounds against the bacterial species employed, using culture tubes a) Nitroxoline proved to be more efficient against species of Ureaplasma spp., against which it presented MIC 50 = 3.13 µM and MIC 90 = 6.25 µM. Considering Mycoplasma species, nitroxoline presented MIC values of 12.5–50 µM b) Nitroxoline showed bactericidal effect against U. parvum , while it showed bacteriostatic effect for U. urealyticum Hof and Juretschke ( 2019 ) Klebsiella pneumoniae Proteus mirabilis a) Case report: a 68-year-old patient with multi-morbidities contracted rectal colonization by multidrug-resistant bacteria b) After a coughing fit, the patient developed difficulty swallowing and was admitted to the hospital's pulmonology department. On X-ray imaging, however, there were no signs of aspiration pneumonia c) Clinical evaluation provided evidence of symptomatic urinary tract infection, supported by signs of urine turbidity, proteinuria, and massive leukocytosis triggered by an indwelling catheter d) Microbiological examination of midstream urine revealed the presence of two bacteria: Klebsiella pneumoniae and Proteus mirabilis .…”

Section: Resultsmentioning

confidence: 99%

“…Among strains of the bacteria studied, nitroxoline presented MICs in 0.25–32 mg/L for E. coli , 1–32 mg/L for K. pneumoniae , 1–16 mg/L for S. aureus , and 2–64 mg/L for E. faecalis . In a case report, Hof and Juretschke ( 2019 ) tested by disc diffusion the susceptibility of Klebsiella pneumoniae and Proteus mirabilis , isolated from a 68-year-old patient who had contracted urinary tract infection by multidrug-resistant bacteria. In the paper, the antibiogram showed that nitroxoline was the only active substance against both pathogens.…”

Section: Resultsmentioning

confidence: 99%

Antimicrobial activity of clioquinol and nitroxoline: a scoping review

Wykowski

Andrade

2022

Arch Microbiol

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Clioquinol and nitroxoline, two drugs with numerous pharmacological properties fallen into disuse for many decades. The first was considered dangerous due to contraindications and the second mainly because was taken as ineffective, despite its known antibacterial activity. In the last decades, the advances in pharmaceutical chemistry, molecular biology, toxicology and genetics allowed to better understand the cellular action of these compounds, some toxicological issues and/or activity scopes. Thus, a new opportunity for these drugs to be considered as potential antimicrobial agents has arisen. This review contemplates the trajectory of clioquinol and nitroxoline from their emergence to the present day, emphasizing the new studies that indicate the possibility of reintroduction for specific cases.

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“…Nitroxoline is an old oral antimicrobial, although not widely available. It has broad activity against MDR uropathogens [223]. With a structurally distinct chemical structure, it is unrelated to other antimicrobial classes.…”

Section: Nitroxolinementioning

confidence: 99%

Antimicrobial pharmacokinetics and preclinicalin vitromodels to support optimized treatment approaches for uncomplicated lower urinary tract infections

Abbott

Roberts

Meletiadis

et al. 2020

Expert Review of Anti-infective Therapy

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Introduction: Urinary tract infections (UTIs) are extremely common. Millions of people, particularly healthy women, are affected worldwide every year. One-in-two women will have a recurrence within 12-months of an initial UTI. Inadequate treatment risks worsening infection leading to acute pyelonephritis, bacteremia and sepsis. In an era of increasing antimicrobial resistance, it is critical to provide optimized antimicrobial treatment.Areas covered: Literature was searched using PubMed and Google Scholar (up to 06/2020), examining the etiology, diagnosis and oral antimicrobial therapy for uncomplicated UTIs, with emphasis on urinary antimicrobial pharmacokinetics (PK) and the application of dynamic in vitro models for the pharmacodynamic (PD) profiling of pathogen response.Expert opinion: The majority of antimicrobial agents included in international guidelines were developed decades ago without well-described dose-response relationships. Microbiology laboratories still apply standard diagnostic methodology that has essentially remained unchanged for decades. Furthermore, it is uncertain how relevant standard in vitro susceptibility is for predicting antimicrobial efficacy in urine. In order to optimize UTI treatments, clinicians must exploit the urine-specific PK of antimicrobial agents. Dynamic in vitro models are valuable tools to examine the PK/PD and urodynamic variables associated with UTIs, while informing uropathogen susceptibility reporting, optimized dosing schedules, clinical trials and treatment guidelines.

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Nitroxoline: an option for the treatment of urinary tract infection with multi-resistant uropathogenic bacteria

Cited by 9 publications

References 16 publications

Compared with Cotrimoxazole Nitroxoline Seems to Be a Better Option for the Treatment and Prophylaxis of Urinary Tract Infections Caused by Multidrug-Resistant Uropathogens: An In Vitro Study

Compared with Cotrimoxazole Nitroxoline Seems to Be a Better Option for the Treatment and Prophylaxis of Urinary Tract Infections Caused by Multidrug-Resistant Uropathogens: An In Vitro Study

Antimicrobial activity of clioquinol and nitroxoline: a scoping review

Antimicrobial pharmacokinetics and preclinicalin vitromodels to support optimized treatment approaches for uncomplicated lower urinary tract infections

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