nitrofurantoin


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Related to nitrofurantoin: nitrofurantoin macrocrystals

nitrofurantoin

 [ni″tro-fu-ran´to-in]
a broad-spectrum antibacterial agent used in treatment of urinary tract infections.

nitrofurantoin

Apo-Nitrofurantoin, Furadantin, Novo-Furantoin

nitrofurantoin macrocrystals

Macrobid, Macrodantin

Pharmacologic class: 5-nitrofuran derivative

Therapeutic class: Anti-infective, urinary tract anti-infective

Pregnancy risk category B

Action

Inhibits bacterial enzymes required for normal cell activity at low concentrations; inhibits normal cell-wall synthesis at high concentrations

Availability

Capsules: 25 mg, 50 mg, 100 mg (macrocrystals)

Capsules (extended-release): 100 mg (macrocrystals)

Oral suspension: 25 mg/5 ml

Tablets: 50 mg, 100 mg (macrocrystals)

Indications and dosages

Active urinary tract infections (UTIs)

Adults: 50 to 100 mg P.O. q.i.d. or 100 mg q 12 hours (extended-release), continued for 1 week, or for 3 days after urine becomes sterile

Children older than 1 month: 5 to 7 mg/kg/day P.O. in four divided doses, continued for 1 week, or for 3 days after urine becomes sterile

Chronic suppression of UTIs

Adults: 50 to 100 mg P.O. at bedtime

Children: 1 mg/kg/day P.O. in one or two divided doses

Contraindications

• Hypersensitivity to drug or parabens (oral suspension)

• Oliguria, anuria, or significant renal impairment

• Pregnancy near term (38 to 42 weeks' gestation), imminent labor onset, labor and delivery

• Infants younger than 1 month

Precautions

Use cautiously in:

• diabetes mellitus, renal impairment

• blacks and patients of Mediterranean or near-Eastern descent (because of possible G6PD deficiency)

• elderly or debilitated patients

• pregnant (to week 32) or breastfeeding patients.

Administration

• As appropriate, obtain specimens for repeat urine culture and sensitivity tests before therapy.

• To avoid GI upset and increase drug bioavailability, give with food or milk.

Adverse reactions

CNS: dizziness, drowsiness, headache, asthenia, peripheral neuropathy, vertigo

CV: chest pain

EENT: nystagmus

GI: nausea, vomiting, diarrhea, abdominal pain, anorexia, parotitis, pancreatitis

Hematologic: eosinophilia, agranulocytosis, thrombocytopenia, leukopenia, granulocytopenia, G6PD deficiency anemia, hemolytic anemia, megaloblastic anemia

Hepatic: hepatitis, hepatic necrosis

Musculoskeletal: arthralgia, myalgia

Respiratory: asthma attacks, pulmonary hypersensitivity reactions including diffuse interstitial pneumonias (with prolonged therapy)

Skin: rash, exfoliative dermatitis, alopecia, pruritus, urticaria, angioedema, photosensitivity, Stevens-Johnson syndrome

Other: drug fever, chills, superinfection (limited to urinary tract), hypersensitivity reactions including anaphylaxis, lupus-like syndrome

Interactions

Drug-drug. Anticholinergics: increased nitrofurantoin absorption and bioavailability

Drugs that can cause pulmonary toxicity: increased risk of pneumonitis

Hepatotoxic drugs: increased risk of hepatotoxicity

Magnesium salts: decreased nitrofurantoin absorption

Neurotoxic drugs: increased risk of neu-rotoxicity

Uricosurics (such as probenecid): decreased renal clearance and increased blood level of nitrofurantoin

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine: increased levels Granulocytes, platelets, hemoglobin: decreased levels

Urine glucose tests using Benedict's reagent or Fehling's solution: false-positive results

Drug-food. Any food: increased drug bioavailability

Patient monitoring

• Monitor patient's response to therapy. Assess urine culture and sensitivity tests.

Watch for and immediately report peripheral neuropathy.

Assess respiratory status. Watch for signs and symptoms of serious pulmonary hypersensitivity reaction.

Monitor CBC and liver function tests closely. Stay alert for evidence of hematologic and hepatic disorders.

• Evaluate patient for rash.

Patient teaching

• Instruct patient to take with food or milk at regular intervals around the clock.

• Advise patient to complete entire course of therapy.

• Tell patient not to take magnesium-containing drugs (such as antacids) during therapy.

• Caution patient not to drive or perform other hazardous activities until he knows how drug affects vision, concentration, and alertness.

Tell patient to immediately report fever, chills, cough, chest pain, difficulty breathing, rash, bleeding or easy bruising, dark urine, yellowing of skin or eyes, numbness or tingling of fingers or toes, or intolerable GI distress.

• Advise female patient to avoid taking drug during pregnancy, especially near term.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and foods mentioned above.

ni·tro·fu·ran·to·in

(nī'trō-fyū-ran'tō-in),
A urinary antibacterial agent with a wide range of activity against both gram-positive and gram-negative organisms; also available as nitrofurantoin sodium for injection.

nitrofurantoin

(nī′trō-fyo͝o-răn′tō-ĭn)
n.
A derivative of nitrofuran, C8H6N4O5, used to treat bacterial infections of the urinary tract.

ni·tro·fu·ran·to·in

(nī'trō-fyūr-an'tō-in)
A nitrofuran compound (O-[5-nitrofurfurylideneamino]hydantoin) with antimicrobial activity against a wide spectrum of gram-positive and gram-negative bacteria.

nitrofurantoin

A drug that damages bacterial DNA and is used to treat urinary tract infections. The drug is on the WHO official list. Brand names are Furadantin, Macrobid and Macrodantin.

ni·tro·fu·ran·to·in

(nī'trō-fyūr-an'tō-in)
Urinary antibacterial agent with a wide range of activity against both gram-positive and gram-negative organisms.
References in periodicals archive ?
Alliance Healthcare and two manufacturers - Morningside and AMCo (now Advanz) are alleged by the CMA to have entered into anticompetitive agreements to keep prices of nitrofurantoin artificially high.
Nitrofurantoin and fosfomycin for extended spectrum beta-lactamases producing Escherichia coli and Klebsiella pneumoniae.
coli revealed lowest percentage of resistance against meropenem (10%, 10.6%, 9.4%), piperacillin-tazobactam (11.2%, 10%, 9.6%), amikacin (15.6%, 11.5%, 12.5%) and nitrofurantoin (13%, 12.2%, 10.4%).
Despite its success, nitrofurantoin did not live up to its purported 96% UTI cure rate--an established number based on study data from the 1950s to 1970s.
The researchers found that 70 and 58 percent of patients receiving nitrofurantoin and fosfomycin, respectively, achieved clinical resolution through day 28 (difference, 12 percent).
Among these women, the most commonly prescribed antibiotics during the first trimester were nitrofurantoin (34.7%), ciprofloxacin (10.5%), cephalexin (10.3%), and trimethoprim-sulfamethoxazole (7.6%).
According to 2011 guidelines from the Infectious Diseases Society of America, nonpregnant women with uncomplicated UTIs should be treated with nitrofurantoin or trimethoprimsulfamethoxazole.
717 that nitrofurantoin was still thought to be appropriate when no other suitable alternative antibiotics were available (Obstet Gynecol.
Appropriateness was determined according to IDSA 2010 recommendations; a regimen of nitrofurantoin 100 mg bid for 5 days or fosfomycin 3 grams single dose was considered appropriate [1].
But surprisingly, nitrofurantoin and cotrimoxazole which are showing good antimicrobial activity against most organisms are least prescribed.
* Nitrofurantoin, a chemotherapeutic compound of the Nitrofuran family, was introduced into clinical practice in 1952.
Trimethoprim-sulfamethoxazole, amoxicillin-clavulanate and nitrofurantoin are commonly chosen drugs for prophylactic treatment.