5-nitro-8-hydroxyquinoline

Nitroxoline (5-nitro-8-hydroxyquinoline) is an old antimicrobial agent with a broad spectrum of pharmacological applications and a unique mechanism of action [1]. Even though it had been known as an effective uroantiseptic since the previous century, its use in the treatment and prevention of urinary tract infections (UTIs) has not been popular in the recent past. At the moment, nitroxoline is commercially available only in Germany, Poland, Croatia, Bulgaria, Romania, Bosnia-Herzegovina and Montenegro [2]. Nonetheless, in interdisciplinary German guidelines nitroxoline is recommended in uncomplicated lower UTIs [3].

As drug resistance in uropathogens is becoming more common, the search for alternative treatment options intensifies. That is why nitroxoline is quickly gaining interest. It is active against a variety of Gram-negative and -positive bacteria, mycoplasmas and Candida spp., while maintaining a reasonably low risk of adverse effects [4].

Unfortunately, there are only a few modern clinical trials assessing nitroxoline, due to its low popularity. Also, older researches often do not meet current scientific standards.

Nonetheless, in this review we examined nitroxoline’s mechanism of action, pharmacokinetics, safety profile and efficacy against common uropathogens, considering their resistance mechanisms. Through a lens focused on the current urological practice, this review seeks to provide a comprehensive overview of nitroxoline as a viable option in treating active uncomplicated lower UTIs, as well as preventing