Efficacy of levofloxacin plus nitrofurantoin in treatment of diabetes mellitus complicated with urinary tract infection

Tang Xinyu; Liu Hongxin; Yin Jincheng

doi:10.3969/j.issn.1672-8157.2025.04.013

Abstract：Objective To explore the efficacy of levofloxacin plus nitrofurantoin in treating diabetes mellitus combined with urinary tract infection and investigate its effect on soluble triggering receptor expressed on myeloid cells-1(sTREM-1),high mobil-ity group box-1 protein(HMGB1),microRNA(miRNA)-15a.Methods A total of 220 patients with diabetes mellitus combined with urinary tract infection admitted to Chongming Hospital Affiliated to Shanghai University of Medicine&Health Sciences from January 2023 to January 2024 were selected and divided into the levofloxacin group(using levofloxacin)and the nitrofurantoin group(using levofloxacin combined with nitrofurantoin)by the random number table method,with 110 in each group.The pathogenic bac-teria conversion rate,clinical efficacy,incidence of adverse reactions and expression levels of blood factors were compared between the two groups.Results After antimicrobial treatment,the urinary pathogenic bacteria conversion rate of 92.73% (102/110)and total therapeutic efficacy rate of 90.91% (100/110)in the nitrofurantoin group were significantly higher than those of the levofloxacin group(77.27% (85/110),73.64% (81/110)),with statistically significant differences(χ2=10.303,11.251,both P<0.05).The incidence of adverse reactions in the combination group was 7.27% (8/110),which was not statistically different from the 8.18% (9/110)in the levofloxacin group(χ2=0.064,P>0.05).The expression levels of serum sTREM-1 and HMGB1((42.93±5.94)ng·mL-1,(5.87±1.54)μg·mL-1)in the nitrofurantoin group were significantly lower than those in the levofloxacin group((56.44±6.71)ng·mL-1,(6.92±2.08)μg·mL-1),and the expression level of miRNA-15a(0.77±0.16)was significantly higher than that in the levofloxacin group(0.53±0.10),and the differences were statistically significant(t=15.812,4.255,13.341,all P<0.05).Conclusion Patients with diabetes mellitus combined with urinary tract infection can be better treated with levofloxacin plus nitrofurantoin since it can significantly increase the conversion negative rate of urine pathogen culture,down-regulate the expression of serum sTREM-1 and HMGB1,and increase the expression level of miRNA-15a in the patients.