nitrofurantoin การใช้

• Nitrofurantoin and its metabolites are excreted mainly by the kidneys.
• Nitrofurantoin and the quinolone antibiotics are mutually antagonistic " in vitro ".
• However, a retrospective chart review may suggest nitrofurantoin is not contraindicated in this population.
• Urinary tract infections can be treated specifically with nitrofurantoin, even in cases of vancomycin resistance.
• Chronic pulmonary reactions caused by nitrofurantoin include diffuse interstitial pneumonitis, pulmonary fibrosis, or both.
• Resistance to nitrofurantoin may be chromosomal or plasmid-mediated and involves inhibition of nitrofuran reductase.
• It is not known which of the actions of nitrofurantoin is primarily responsible for its bactericidal activity.
• For the same reason, nitrofurantoin should not be given to pregnant women after 38 weeks of pregnancy.
• At the concentrations achieved in urine ( > 100 ?g / ml ), nitrofurantoin is a bactericide.
• Nitrofurantoin should not be used in patients with a creatinine clearance of 60 ml / min or less.
• Nitrofurantoin exerts greater effects on bacterial cells than mammalian cells because bacterial cells activate the drug more rapidly.
• The banned drugs are chloramphenicol, dimetridazol, ronidazole, furaltadone, furazolidone, nitrofurantoin, nitrofurazone and nitrovin.
• Several trials comparing nitrofurantoin to other commonly used agents have shown this drug results in similar cure rates for uncomplicated UTIs.
• A meta analysis of four out of twenty-two available studies on the safety of nitrofurantoin found no increased risk.
• Nitrofurantoin is contraindicated in patients with glucose-6-phosphate dehydrogenase deficiency because of risk of intravascular hemolysis resulting in anemia.
• Increasing bacterial antibiotic resistance to other commonly used agents, such as fluoroquinolones and trimethoprim / sulfamethoxazole, has led to increased interest in using nitrofurantoin.
• Nitrofurantoin is not recommended for the treatment of pyelonephritis, and intra-abdominal abscess, because of extremely poor tissue penetration and low blood levels.
• One, nitrofurantoin, may require seven days of therapy to cure the infections, compared to only three days for the current front-line drugs.
• Several trials on the safety and ophthalmic malformations, cleft lip and cleft palate, and atrial septal defect, were more common in neonates exposed to nitrofurantoin during pregnancy.
• It is important to recognize nitrofurantoin as possible cause of symptoms and discontinue the drug when the suspicion of pulmonary side effects arises as it can be reversible if the drug is stopped early.