Efficacy and Safety of Nitrofurantoin in the Treatment of Uncomplicated Urinary Tract Infections in Adults

Inclusion Criteria: * non-pregnant women and men aged above 18 years old * presence of ≥ 2 signs or symptoms suggestive of a UTI (dysuria, urinary frequency, urgency, suprapubic pain) with onset 10 days before enrollment * asymptomatic patients with available positive urine culture * pyuria defined as positive leucocyte esterase (LE) test with any color change after two minutes * collection of clean-voided midstream urine sample for culture and susceptibility testing to confirm bacteriuria * normal renal function (defined as blood creatinine \< 1.4 mg/100 ml) * able to take oral medication on an outpatient basis * written informed consent before enrollment Exclusion Criteria: * suspicion of complicated UTI (presence of fever above 38°C, flank pain, known urologic structural abnormality) or prostatitis * negative urine dipslide results (uropathogen \< 100000 CFU (colony-forming units)/mL) or presence of nitrofurantoin resistant isolate uropathogens or mixed cultures of more than two isolates * symptoms of UTI within the past 4 weeks * evidence of predisposing factor to UTI (e.g. calculi, stricture, primary renal disease like polycystic renal diseases and neurogenic bladder) * medical history of anaemia, complicated diabetes mellitus, peripheral neuropathy, vitamin B deficiency, renal insufficiency, other significant renal, hepatic or lung diseases * medical history of glucose-6-phosphate dehydrogenase deficiency (G6PD) * electrolytes disorders * pregnant, breast-feeding women or not using medically accepted, effective method of birth control * history of nitrofurantoin hypersensitivity * use of systemic bacteriological agent within 48 hours before enrollment