Nitrofurantoin – marketed under names such as Macrodantin and Macrobid – is used in the treatment of bladder infections. It is not effective at treating kidney infections. Here, we learn more about the essential facts behind nitrofurantoin pharmacology.
Prescribing nitrofurantoin for UTIs has become more common. Before this, fluoroquinolones and trimethoprim-sulfamethoxazole were used (and still are used) in the treatment of urinary tract infections (UTIs). Resistance to these drugs has increased, however. As a result, more eyes are now focussed on nitrofurantoin as a clinically effective means to treat this common condition.
Nitrofurantoin is effective at treating uncomplicated urinary tract infections. It remains a first-line agent. Other first-line drugs include trimethoprim and amoxicillin.
There are two great advantages of nitrofurantoin in the treatment of UTIs:
With these facts in mind, let’s take a closer look at the pharmacology of nitrofurantoin, how the drug works to exert its therapeutic effect.
Nitrofurantoin works by damaging bacterial DNA.
In bacterial cells, nitrofurantoin is reduced by nitrofuran reductase. The resulting metabolite is highly reactive and attacks ribosomal proteins, DNA and pyruvate metabolism. It is not yet known which specific action is responsible for its bactericidal activity.
Nitrofurantoin is active against both Gram-positive and Gram-negative causes of urinary tract infections – including E. coli and S. saprophticus, some of the most common causes of UTIs.
Side effects caused by nitrofurantoin include:
Prolonged use of nitrofurantoin is likely to cause more serious effects:
Other potential side effects include dizziness, drowsiness, pruritis and malaise.
When we talk about the clinical pharmacology of nitrofurantoin, we need to think about the following factors:
Nitrofurantoin remains an important drug in the treatment of urinary tract infections. Here, we have outlined the broad details of this drug – how it works, what side effects it can cause, and the clinical factors that underpin it.
That concludes our rapid revision of nitrofurantoin pharmacology! Check back to our PharmaFactz blog soon for more exclusive content to help you master the science of drugs and medicines!