What is another name for nitrofurantoin in an adult female patient with an uncomplicated urinary tract infection?

Alternative Names for Nitrofurantoin

Nitrofurantoin is also known as nitrofurantoin macrocrystals or nitrofurantoin monohydrate/macrocrystals. 1

Brand Name Formulations

The drug is available in different crystalline formulations that affect its pharmacokinetic properties:

• Nitrofurantoin macrocrystals - This is the standard formulation referenced in FDA labeling 1
• Nitrofurantoin monohydrate/macrocrystals - This formulation is specifically recommended in clinical guidelines at 100 mg twice daily for 5 days for uncomplicated UTIs 2

Clinical Context for Uncomplicated UTI

For an adult female with uncomplicated urinary tract infection, nitrofurantoin is positioned as a first-line treatment option alongside trimethoprim-sulfamethoxazole and fosfomycin 3, 2. The standard dosing is 100 mg twice daily for 5 days 2, though some older literature references 100 mg three times daily 4.

Key Advantages of Nitrofurantoin

• Minimal resistance patterns - Despite over 60 years of use, nitrofurantoin maintains excellent activity against E. coli and other common uropathogens 5, 6
• Low propensity for collateral damage - It has minimal impact on normal vaginal and fecal flora compared to broader-spectrum agents 2
• Superior efficacy - A 2018 randomized trial demonstrated 70% clinical resolution with 5-day nitrofurantoin versus 58% with single-dose fosfomycin at 28 days 4

Important Prescribing Considerations

• Contraindicated in late pregnancy (last trimester) and in any degree of renal impairment 5
• Serious but rare adverse effects include pulmonary toxicity (0.001%) and hepatic toxicity (0.0003%), primarily with long-term use 3
• Common mild adverse effects include nausea (3%) and diarrhea (1%) 4