1950s drugs used to treat cystitis

Hyderabad: Cystitis is an infection in the urinary bladder, commonly seen in women. To treat this infection doctors are using antibiotics from the 1950s when modern antibiotics are far more effective, according to a recent study published in JAMA.

Doctors from the University of Geneva have found that the antibiotic nitrofurantion, which was approved in 1953, and fostomycin, which was approved in 1971 are being used in India. These drugs are not up to the standards of present-day antibiotics and must be tested before re-introducing in the market.

Urologists in the city contest this and say nitrofurantion and fostomycin are very effective and there is no documented case of harm to patients.

Dr K. Subrahmanyam, senior consultant urologist and transplant surgeon at Apollo Hospitals explained, “Nitrofurantoin is a very old but very effective drug. It has been used and is very useful to treat uncomplicated infections. Fosfomycin has an advantage of a single dose use and is effective in treating uncomplicated cystitis. These drugs have been tested properly and standards are the same as the new one. Nitrofurantion is occasionally found to cause gastrointestinal side effects in some patients. These are a few cases which have been properly documented. But this is a side-effect of the drug and not got anything to do with its standards.”

Nitrofurantion is also effective for chemotherapy patients with recurrent infections. The drug was stopped for some time as there is a method called ‘recycling of antibiotics’ which is followed by the medical fraternity. The drug was introduced in the 1950s but stopped in the late ‘80s and is now being put to use again since 2010 as it was found to be effective in fighting bacteria.

Due to increasing incidence of antibiotic resistance, a decision was taken years ago that powerful antibiotics must be stopped for a few decades and then re-introduced later to better fight infections.

Dr P. Vamsi Krishna, consultant urologist and transplant surgeon, said that the emergence of drug resistant bacteria led to the idea of stopping drugs for a span of time and introducing another drug during that time period. 

"This was to destroy the bacteria. But time and again it has been found that the bacteria are becoming resistant to drugs because of their over-exposure to the drug. The use of antibiotics in the poultry industry is one of the major reasons for the development resistance as the food chain is being fed with too many antibiotics."