What is nitrofurantoin ?
Nitrofurantoin is an antibiotic (a bactericidal agent) to be used in fighting urinary tract infections. The agent has since 1953 in the international market and sold in the Netherlands under the brand names Furabid and Furadantine.
Indications
Nitrofurantoin is highly excreted by the kidneys and therefore reaches high concentrations in the urine. It penetrates almost into the tissues. This makes nitrofurantoin is used only with uncomplicated urinary tract infections. Uncomplicated UTIs are infections involving the microorganism only attaches to the lining of the urinary tract and therefore there is no intrusion into the tissues, as may be suspected if there is fever exists. Furthermore, nitrofurantoin initially used only in patients without additional risk of complications. This means that the first choice in otherwise healthy women over 12 years, is used. In other patients is usually prescribed a different antibiotic. In pregnant women, this means first choice for a course of 7 days, when she gave birth to at least not nearly have.
In addition to the treatment of urinary tract infections nitrofurantoin will also be as a precautionary measure (prophylactic) used in the application of a urinewegkatether or surgery to the urinary tract. Women who often have urinary tract infections (more than 6 per year) may swallow nitrofurantoin precaution.
Nitrofurantoin is only available on prescription in capsules of 50 and 100 mg, modified release capsules of 100 mg and a suspension of 10mg / ml; 100 ml.
Nitrofurantoin side effects
Nitrofurantoin can cause some side effects. The most come disturbances to the gastro-intestinal tract for, such as nausea, vomiting, decreased appetite and diarrhea. Headaches, dizziness and drowsiness occur. There are some serious side effects that may occur with the use of nitrofurantoin, such as damage to nerves in arms and legs (peripheral neuropathy). This is more common in people who have impaired renal function or a higher age and sometimes no cure. Also, nitrofurantoin can cause symptoms in the lungs, probably due to an allergic reaction. Patients may then suffer from fever, shortness of breath, coughing and chest pain.
Interactions
Nitrofurantoin may reduce the effect of antibiotics from the quinolone group. Further, the agent may probenecid ensure that the kidney tubules in the less nitrofurantoin urine excretion, whereby the operation is reduced.
Contraindications
In some situations, nitrofurantoin can not be used. Some people are allergic to nitrofurans. People who are severely impaired renal function, anemia, a deficiency G6DP or previous severe side effects of the drug nitrofurantoin can also better not to use.
Action
Nitrofurantoin inhibits bacterial enzymes which are involved in the Krebs-cycle, such as pyruvate dehydrogenase, citrate synthetase and maleate dehydrogenase. As a result, the bacterium is unable to produce enough energy to grow and to stay alive. The agent acts against gram-positive and gram-negative bacteria. Some groups of bacteria, such as Pseudomonas, Serratia and most species of Proteus have been resistant to nitrofurantoin. Nitrofurantoin works better in acidic urine than in neutral or alkaline urine.