Nitrofurantoin is concentrated in the urine, leading to higher and more effective levels in the urinary tract than in other tissues or compartments. However, a retrospective chart review may suggest nitrofurantoin is not contraindicated in this population. Nitrofurantoin should not be used in patients with a creatinine clearance of 60 mL/min or less. In renal impairment, the concentration achieved in urine may be subtherapeutic. Nitrofurantoin and its metabolites are excreted mainly by the kidneys. Resistance to nitrofurantoin may be chromosomal or plasmid-mediated and involves inhibition of nitrofuran reductase. It is not known whether this is of clinical significance, but the combination should be avoided. Nitrofurantoin and the quinolone antibiotics are mutually antagonistic in vitro. It is bacteriostatic against most susceptible organisms at concentrations less than 32 μg/mL. Nitrofurantoin is contraindicated in patients with decreased renal function (CrCl 100 μg/mL), nitrofurantoin is a bactericide. It is 75% monohydrate and 25% macrocrystals. Monohydrate/macrocrystals - (Macrobid) – 100 mg capsules – taken once every 12 hours or 2 times a day (written on prescriptions as BID, which is the last part of the trade name MacroBID).Macrocrystals - (Macrodantin, Furadantin) – 25, 50, or 100 mg capsules – taken once every 6 hours.There are two formulations of nitrofurantoin: A 2015 meta analysis found no increased risk from first trimester use in cohort studies that was a slight increase of malformations in case control studies. They remain a first line treatment in the second trimester. The American College of Obstetricians and Gynecologists states that while they can be used in the first trimester other options may be preferred. Įvidence of safety in early pregnancy is mixed as of 2017. Newborns of women given this drug late in pregnancy had a higher risk of developing neonatal jaundice. It however should not be used in late pregnancy due to the potential risk of hemolytic anemia in the newborn. It is one of the few drugs commonly used in pregnancy to treat UTIs. Nitrofurantoin is pregnancy category B in the United States and pregnancy category A in Australia. Many or all strains of the following genera are resistant to nitrofurantoin: Īntibiotic susceptibility testing should always be performed to further elucidate the resistance profile of the particular strain of bacteria causing infection. It is used in the treatment of infections caused by these organisms. Nitrofurantoin has been shown to have good activity against: Nitrofurantoin is not recommended for the treatment of pyelonephritis, and intra-abdominal abscess, because of extremely poor tissue penetration and low blood levels. The efficacy of nitrofurantoin in treating UTIs combined with a low rate of bacterial resistance to this agent makes it one of the first-line agents for treating uncomplicated UTIs as recommended by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Increasing bacterial antibiotic resistance to other commonly used agents, such as trimethoprim/sulfamethoxazole and fluoroquinolones, has led to increased interest in using nitrofurantoin. This antibiotic is very unlikely to affect your ability to drive, but if you find it does make you feel sleepy or dizzy then it's best to avoid driving while taking it.Current uses include the treatment of uncomplicated urinary tract infections (UTIs) and prophylaxis against UTIs in people prone to recurrent UTIs. However, it's best to avoid drinking alcohol while you have a UTI - drink plenty of water instead to help flush the bacteria out of your bladder and urinary tract. It also increases the risk of the bacteria becoming resistant to the antibiotic.Ĭan I drink alcohol while taking nitrofurantoin?Īlcohol doesn't affect nitrofurantoin itself, so it won't cause a problem with the medication if you drink in moderation while taking it. If you stop treatment early because you feel better this makes it more likely that your infection will come back. It's important to complete the prescribed course of nitrofurantoin when treating a UTI.This is normal and nothing to worry about - it's due to the colour of the medicine. Nitrofurantoin can turn your urine a dark yellow or brown colour.Things to know before taking nitrofurantoin:
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