Guay D R
University of Minnesota, Institute for the Study of Geriatric Pharmacotherapy, and College of Pharmacy and Partnering Care Senior Services, HealthPartners, Minneapolis 55455, USA.
Drugs. 2001;61(3):353-64. doi: 10.2165/00003495-200161030-00004.
There have been few recent reviews of the nitrofurans in the literature, and none include recently available data on the use of nitrofurazone (nitrofural) in the prevention of catheter-associated urinary tract infection (CAUTI). Nitrofurazone and nitrofurantoin are the only nitrofurans that have become established in clinical use in the 20th century. These 2 nitrofurans have remained clinically useful against a wide spectrum of gram-positive and gram-negative bacteria, including many strains of common urinary tract pathogens. Today, the primary use of nitrofurantoin is as an oral antibacterial treatment for genitourinary infections. Nitrofurazone is primarily used as a topical antibacterial agent in burns and skin grafts and recently was approved for the prophylaxis of CAUTI. The recent development of a nitrofurazone-impregnated catheter as a novel modality in the prevention of CAUTI reflects a renewed interest in the effectiveness of nitrofurans. In an era when concern about bacterial resistance to many anti-infective agents is growing, the nitrofurans have continued to be active against organisms that have developed resistance to antibacterials. The presence of multiple mechanisms of action for the nitrofurans might be expected to reduce the ability of bacteria to develop resistance. Considering that an emergence of resistance to the nitrofurans has not appreciably occurred after several decades of clinical use, the nitrofurans may be unique among common antibacterial agents in this regard.
近期文献中对硝基呋喃类药物的综述较少，且均未纳入有关呋喃西林（硝基糠醛）预防导管相关尿路感染（CAUTI）的最新可用数据。呋喃西林和呋喃妥因是20世纪已确立临床应用的仅有的两种硝基呋喃类药物。这两种硝基呋喃类药物对多种革兰氏阳性菌和革兰氏阴性菌仍具有临床疗效，包括许多常见的尿路病原体菌株。如今，呋喃妥因的主要用途是作为泌尿生殖系统感染的口服抗菌治疗药物。呋喃西林主要用作烧伤和皮肤移植的局部抗菌剂，最近被批准用于预防CAUTI。一种含呋喃西林的导管作为预防CAUTI的新方法的最新研发，反映出人们对硝基呋喃类药物有效性的重新关注。在一个对许多抗感染药物的细菌耐药性担忧日益增加的时代，硝基呋喃类药物对已对抗菌药物产生耐药性的微生物仍具有活性。硝基呋喃类药物存在多种作用机制，可能会降低细菌产生耐药性的能力。鉴于经过数十年临床应用后，硝基呋喃类药物并未明显出现耐药性，在这方面，硝基呋喃类药物在常见抗菌药物中可能是独一无二的。
