Diseases

Nitrofurantoin

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The active substance nitrofurantoin is an antibiotic and is used to treat bacterial urinary tract infections. Although previously used only as a second-line antibiotic, it has been a first-line treatment since 2011, according to the current guidelines. Read more about the effects and use of nitrofurantoin, side effects and other important information.

ArtikelübersichtNitrofurantoin
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This is how nitrofurantoin works

The antibiotic nitrofurantoin is a so-called prodrug: It is converted into its active form only at the site of action (in the urinary tract). The conversion is done by bacterial enzymes after the active substance has been absorbed into the blood from the intestine and as soon as it is released to the outside via the urinary tract: nitrofurantoin penetrates the bacteria present in a urinary tract infection. Inside the bacterial cells, certain enzymes (nitroreductases), which are not present in humans, convert nitrofurantoin into the active, active form. This attacks the bacterial genome and dismembers it, but also has a targeted destructive effect on other metabolic enzymes vital for the cell.

Because the active form of nitrofurantoin has many different targets in the bacterial cell, the likelihood that the bacteria will develop resistance to the antibiotic is quite low.

The antibiotic not only inhibits the growth of bacteria but also kills them selectively, which is why nitrofurantoin is referred to as a "bactericidal antibiotic".

Uptake, breakdown and excretion of nitrofurantoin

Nitrofurantoin reaches the highest urine levels about four to five hours after ingestion. About half of the drug taken is degraded to inactive metabolites. These are also excreted in the urine and can lead to a safe browning of the urine.

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When is nitrofurantoin used?

The antibiotic nitrofurantoin is used to treat acute uncomplicated cystitis. "Uncomplicated" means that there are no symptoms that speak for worse diseases or illnesses - such as fever, nausea, vomiting, kidney, back or flank pain, vaginal itching or vaginal discharge.

In certain cases, such as a congenital or acquired constriction of the urinary tract or repeated chronic urinary tract infections, preventive treatment with nitrofurantoin may also be considered.

In an acute infection, the duration of nitrofurantoin treatment is usually five to seven days, but it can be up to a maximum of six months to prevent it, but at a lower dose.

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This is how nitrofurantoin is used

Nitrofurantoin is usually taken throughout the day in three to four single doses of 100 milligrams. In the case of delayed-release capsules (so-called "delayed-release capsules"), the dosage is reduced to two to three capsules of 100 milligrams. The intake takes place at intervals of six to eight hours for a meal with a glass of water.

The antibiotic should be taken in an acute infection as long as prescribed by the doctor - even if the symptoms improve before.

In the case of bowing, lower doses are chosen, usually one tablet in the evening after the last urination.

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What side effects does nitrofurantoin have?

During therapy with nitrofurantoin, more than ten percent of those treated experience side effects such as dizziness, impaired locomotor coordination, eye tingling, allergic reactions such as itching, redness, rash, and tissue fluid retention. In case of allergic reactions, a doctor should be informed.

Further nitrofurantoin side effects in one in ten to one hundred patients are headache, loss of appetite, nausea, vomiting, pneumonia, cough and chest pain.

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