Spectrum Of Activity
Only for urinary tract infections. Not for use in pyelonephritis or prostatitis due to lack of penetration.
Interstitial pneumonitis and fibrosis especially with prolonged use.
Contraindicated for CrCl < 30 due to lack of urinary penetration at low CrCl
Two formulations exist for UTI treatment:
Nitrofurantoin monohydrate/macrocrystal - Macrobid - BID dosing (Formulary)
Nitrofurantoin macrocrystal - Macrodantin - QID dosing
BEERS list - nitrofurantoin prophylaxis is not recommended in elderly patients
Antimicrobial class: Nitrofuran
Pregnancy category: Nitrofurantoin may be used to treat infections during pregnancy:
Use during the first trimester should be limited to situations where no alternative therapies are available as evidence for association with birth defects is mixed.
Use during the second and third trimester (except as below) as a first line agent is appropriate
Contraindicated in pregnant patients at term (38 to 42 weeks' gestation), during labor and delivery, or when the onset of labor is imminent due to the possibility of hemolytic anemia in the neonate
Alternative antibiotics should be used in pregnant patients with G-6-PD deficiency
See ACOG 717 2017
Average serum half life: 1 hour
Biliary penetration: None
CSF penetration: None
Lung penetration: None
Urine penetration: Therapeutic