Nitrofurantoin

Nitrofurantoin is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Nitrofurantoin (50–100 mg PO macrocrystals q6h or 100 mg PO dual-release formulation q12h for 5–7 days) is a bactericidal oral antibiotic used for uncomplicated UTIs except those caused by Proteus, P. aeruginosa, or Serratia. The drug is metabolized by bacteria into toxic intermediates that inhibit multiple bacterial processes. It has had a modest resurgence in use, as it is frequently effective for uncomplicated VRE UTIs.
  • Prolonged therapy is associated with chronic pulmonary syndromes that can be fatal and should be avoided. Nitrofurantoin should not be used for pyelonephritis or any other systemic infections and should be avoided in patients with renal dysfunction.

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General Principles

  • Nitrofurantoin (50–100 mg PO macrocrystals q6h or 100 mg PO dual-release formulation q12h for 5–7 days) is a bactericidal oral antibiotic used for uncomplicated UTIs except those caused by Proteus, P. aeruginosa, or Serratia. The drug is metabolized by bacteria into toxic intermediates that inhibit multiple bacterial processes. It has had a modest resurgence in use, as it is frequently effective for uncomplicated VRE UTIs.
  • Prolonged therapy is associated with chronic pulmonary syndromes that can be fatal and should be avoided. Nitrofurantoin should not be used for pyelonephritis or any other systemic infections and should be avoided in patients with renal dysfunction.

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