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My husband has been taking Norfloxacin for the treatment of a long standing urinary tract infection. It has proved to be the best way of keeping his condition in check.

The manufacturer Merck Sharp and Dohme have reported "supply problems" and the UNTINOR tablets are no longer available. What alternative source is there for the drug Norfloxacin?

Alternative drugs for controlling the infections have proved unsuccessful in the past for controlling the infection.

Thank you for your help.

Hi

This must be a real concern for you.

I must confess I am not aware of a supply issue and if you speak to the GP or pharmacist there may be another generic supplier of the drug which may have a different trade name but be the same active ingredient. Norfloxacin is one of a group of antibiotics and there are similar antibiotics which may well be equally as effective. A sample of urine sent and cultured will also identify the appropriate antibiotics.

My only concern is that it is more unusual for men to get urine infections than women and men who get recurrent urine infections should be investigated to find the reason why they are getting infections. It doesn't mean there is anything sinister but it is important to treat the cause of the infection as well as the infection itself. He may well have been seen and investigated already, but if not the it is worth him having that discussion with the GP.

Hope this helps.

Thanks for your kind reply.

The supply problem is due to a failed CPMG inspection carried out by the MHRA. I phoned both the manufacture and the MHRA and they both are unable to say when the drug will be available again.

My husband had a major bowel operation 4.5 years ago and when he left hospital he had this urinary infection. They did a culture and it showed the bug responds to Norfloxacin. He has taken 400g once per day for the last 2.5 years. When he tried to cut down his infection problem resurfaced and when he has recently tried another drug (due to the supply problem), his infection resurfaced again.

We know that he will have to try other drugs and have a urine sample reinvestigated but if we cannot find a suitable alternative, can anything be done to speed up matters with the MHRA so that the Norfloxacin can be available again?

Thanks again for your help.

It sounds from your reply that other options have been tried and you understand that long term treatment is far froim ideal, particularly with regards to bacterial resistance in the future. However, if this drug is the only 1 that works, it must be a huge concern - I presume you have tried alternative quinolone drugs such as ofloxacin or ciprofloxacin?

Thanks again for this reply.

Today my husband was prescribed ofloxacin and a urine sample has been sent off.

Why do you think the infection keeps recurring? We are very worried about long term bacterial resistance, but what other choice have we than carrying on with the drug that is presently keeping the condition under control.

The urology department were unable to suggest any other treatment 4 years ago. Do you think there could have been any clinical developments since he was last seen by a specialis?. Is it worth asking for a re-referral?

We are grateful for your comments.

It might well be a good idea - the trouble is that this solution runs the risk of failing in the future - worth thinking about any underlying reason for recurrent infection, possible involvement of a microbiologist if necessary - so I think a re-referral for review would be a good plan.