If persistence or reappearance of bacteriuria occurs after treatment with Macrodantin, other therapeutic agents with broader tissue distribution should be selected. Urine specimens for culture and susceptibility testing should be obtained before and after completion of therapy. Consequently, many patients who are treated with Macrodantin are predisposed to persistence or reappearance of bacteriuria. Nitrofurantoins lack the broader tissue distribution of other therapeutic agents approved for urinary tract infections. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. To reduce the development of drug-resistant bacteria and maintain the effectiveness of Macrodantin and other antibacterial drugs, Macrodantin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses. The summaries of these monographs are openly available on is specifically indicated for the treatment of urinary tract infections when due to susceptible strains of Escherichia coli, enterococci, Staphylococcus aureus, and certain susceptible strains of Klebsiella and Enterobacter species.
What is nitrofurantoin used for full#
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Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments. However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome. The decision as to which drug is chosen should be based on the clinical condition of the pregnant woman and local prescribing guidelines.Įxposure to nitrofurantoin at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring. Any risks to the fetus from the drugs used to treat maternal UTI should be weighed against the potential adverse effects for the mother and fetus from an untreated infection. Where possible, antibiotic choice should be informed by culture and sensitivity tests, however if treatment is required urgently or before test results become available, then nitrofurantoin may be considered where clinically appropriate. Nitrofurantoin use is generally avoided in pregnant patients during labour and delivery because of the theoretical possibility of haemolytic anaemia in the fetus, or in the neonate due to immature erythrocyte enzyme systems. It has also been associated with haemolysis in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Nitrofurantoin in the non-pregnant patient can, in rare cases, cause serious adverse reactions including peripheral neuropathy, pulmonary toxicity, and fatal hepatic injury. No studies have investigated the risk of adverse neurodevelopmental outcomes.
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No increased risk of spontaneous abortion, intrauterine death, low birth weight or preterm delivery has been identified, although an increased incidence of neonatal jaundice has been observed in infants exposed to nitrofurantoin in the month preceding delivery. Individual studies have suggested a possible increased risk of hypoplastic left heart, talipes, hypospadias, an/microphthalmia, ASD, and cleft lip/palate however these findings have not been confirmed in other studies and the increase in risk (if any) of congenital malformations following exposure to nitrofurantoin is likely to be small, especially given that systemic absorption and transfer to the fetus is low. There is no strong evidence of an association between in utero nitrofurantoin exposure and an overall increased risk of congenital malformations or of any specific type of malformation. It is specifically indicated for the treatment of infections due to susceptible strains of Escherichia coli, Enterococcus, Staphylococcus, Citrobacter, Klebsiella and Enterobacter. Nitrofurantoin is an antibiotic used for the treatment of, and prophylaxis against, acute or recurrent uncomplicated lower urinary tract infections (UTIs) or pyelitis.