A prospective study of the efficacy of low dose nitrofurantoin in preventing urinary tract infections in spinal cord injury patients, with comments on the role of pseudomonads.

From the results we obtained it seems clear that, even in the presence of Foley catheters and a history of previous urinary infections, low dose antibacterial therapy is effective in preventing repeated invasion of the bladder urine by pathogenic organisms in spinal cord injured patients. It should be emphasised however that the quality of catheter care must also be of high standard and that antibacterials alone cannot compensate for poor care. Nitrofurantoin in the dose we use has proven to be non-toxic and free of side effects, and has not resulted in the emergence of drug resistant bacterial strains. Moreover it would seem that pseudomonas organisms may, in the absence of traumatic catheter techniques be safely left to browse undisturbed in the neuropathic bladder.