Uses
Adult doses of nitrofurantoin for a urinary tract infections can be 100mg two times daily, or 50mg four times daily for seven days. For less severe cases of UTIs, the dosage may be prescribed as shortened to 3 days. The pediatric dose is 5–7 mg/kg/day in four divided doses. or when in 25 mg/5ml oral suspension then pediatric dose is 3 mg/kg/day in four divided doses. Nitrofurantoin should be taken with food, as this improves the absorption of the drug by 45%.
Nitrofurantoin is only clinically proven for use against E. coli or Staph. saprophyticus. It may also have in vitro activity against:
- Coagulase negative staphylococci
- Enterococcus faecalis,
- Staphylococcus aureus,
- Streptococcus agalactiae,
- Citrobacter species, and
- Klebsiella species,
and is used in the treatment of infections caused by these organisms. Many or all strains of the following are resistant to nitrofurantoin:
- Enterobacter species
- Klebsiella species
- Acinetobacter species,
- Morganella species,
- Proteus species,
- Providentia species,
- Serratia species,
- Pseudomonas species.
Nitrofurantoin must never be used to treat pyelonephritis, prostatitis, renal abscess, and pyeloempyema because of extremely poor tissue penetration and low blood levels. Urinary catheter infections may be treated with nitrofurantoin if there are no systemic features; the catheter must be changed after 48 hours of antibiotics and treatment is ineffective if the catheter is not replaced or removed.
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