Nitrofurantoin is an antibiotic that works against a broad-spectrum of bacteria. Nitrofurantoin has been used effectively for a long time for the treatment of acute lower urinary tract infections in adults, children and pregnant women. Let’s get to know how it works, uses and precautions to take before use.
Overview about Nitrofurantoin
Nitrofurantoin is a synthetic antibacterial drug which is known to work against a broad spectrum of bacteria and is particularly effective against the main uropathogens, hence its use for the treatment of urinary tract infections. Resistance to nitrofurantoin has remained virtually unchanged since it first came in use.
How does Nitrofurantoin work?
The exact mechanism of action is unknown but it is known to inhibit several bacterial enzymes thereby interfering with carbohydrate metabolism in bacteria. Nitrofurantoin has also been noted to cause inhibition of bacterial cell wall synthesis and DNA/RNA synthesis.
Nitrofurantoin is available as –
The drug is available in the form of capsules or tablets and oral suspensions, to be taken by mouth.
Uses and benefits of Nitrofurantoin
Nitrofurantoin is used to treat acute, uncomplicated urinary tract infections and is specifically active against uropathogens (pathogens causing urinary tract infections).
Nitrofurantoin is particularly effective against many multi-drug resistant bacteria.
Nitrofurantoin is, overall, a relatively safe drug. Side-effects usually occur due to long-term usage and include –
- Eating disorder, nausea, vomiting
- Darkening of urine.
- Skin eruption – red, itchy bumps on the skin.
- Hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency in red blood cells.
- Peripheral neuropathy – characterized by tingling, numbness and abnormal sensations in the affected area.
- Oral and/or vaginal fungal infection.
- Nitrofurantoin-induced liver toxicity is a rare event.
- Acute pulmonary reaction syndrome – characterized by the sudden onset of fever, chills, cough, body pain and breathing difficulties.
Contraindications of Nitrofurantoin
- Nitrofurantoin should not be used in patients with known hypersensitivity to nitrofurantoin.
- Nitrofurantoin should not be used in patients with significant impairment of kidney function.
- Nitrofurantoin is contraindicated in pregnant patients during pregnancy term (38-42 weeks), when the onset of labor is forthcoming and during labor and delivery
- Nitrofurantoin is contraindicated in children less than one month of age.
- Nitrofurantoin is contraindicated in patients with a previous history of jaundice/liver dysfunction associated with nitrofurantoin.
- Nitrofurantoin should not be used for the treatment of kidney diseases such as pyelonephritis or perinephric abscesses.
Dosage and dosage warnings about Nitrofurantoin
- The usual adult dose of Nitrofurantoin is 50-100 mg four times a day.
- Pediatric dose ranges between 5-7 mg/kg of body weight/day, given in four divided doses (contraindicated in neonates i.e. children less than one month of age).
- Nitrofurantoin must be taken after meals (ideally breakfast and dinner) for better drug absorption in the body.
- It must be emphasized that Nitrofurantoin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by bacteria.
- Kindly note: Patients must complete the full course of therapy; even if they start feeling well before completion of the complete drug regimen.
- Dose reduction is needed in patients suffering from kidney and liver diseases.
- Nitrofurantoin should not be used to treat viral infections like common cold, flu etc.
- Nursing mothers – Trace amounts of Nitrofurantoin have been identified in human breast milk. You must always consult your doctor and make an informed decision based upon the fact that this drug can potentially cause serious adverse reactions in nursing neonates, taking into account the importance of the drug to the mother.
- Patients must never alter/stop the drug regimen without doctor’s consent. If the medicine is stopped in between, the symptoms might reappear or may get aggravated. This can also increase the risk of developing bacterial resistance to the drug.
- Concomitant antacid therapy can result in decreased absorption of Nitrofurantoin in the body.
- Uricosuric drugs such as probenecid and sulfinpyrazone (known to increase the excretion of uric acid in the urine) should not be administered along with
- Nitrofurantoin can modify a number of laboratory test results such as –
- urinary creatinine values may be elevated
- glucose determination using Benedict´s solution may yield a false-positive result
- Levels of bilirubin, alkaline phosphatase, and blood urea nitrogen may be spuriously elevated.
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