Antibacterial activity of nitroxoline and sulphamethizole alone and in combination in urinary tract infections

In vitro studies on the antibacterial activity of nitroxoline and sulphamethizole, alone and in combination, were undertaken and minimal inhibitory concentrations (MICs) determined on a range of urinary pathogens. Eighty per cent of the strains tested were sensitive to less than or equal to 16 mg/l of nitroxoline, and all strains, including Pseudomonas aeruginosa and Streptococcus faecalis, were sensitive to less than or equal to 64 mg/l of nitroxoline. No synergism could be demonstrated with sulphamethizole, but the combination was antagonistic when tested against strains of Ps. aeruginosa and Strep. faecalis. An in vivo study on 10 volunteers showed excellent urinary levels of nitroxoline and sulphamethizole after an oral dose of 160 mg of each agent, and 6-hour urinary nitroxoline levels were greater than or equal to 64 mg/l in 9 of the 10 subjects, and sulphamethizole levels were greater than or equal to 64 mg/l in all 10 subjects. Laboratory findings suggest that nitroxoline and sulphamethizole are both suitable agents for use in urinary tract infections caused by organisms sensitive to these agents, but there appears to be litte advantage in using them in combination.