From the Guidelines
Yes, Macrobid (Nitrofurantoin) is an antibiotic.
Overview of Nitrofurantoin
- Nitrofurantoin is commonly used to treat urinary tract infections (UTIs) [ 1 ].
- It is a first-line agent for re-treatment of UTIs due to its low resistance rates [ 1 ].
Usage and Recommendations
- The American College of Physicians recommends prescribing short-course antibiotics, including nitrofurantoin, for uncomplicated cystitis [ 1 ].
- Nitrofurantoin is typically prescribed for 5 days for uncomplicated bacterial cystitis [ 1 ].
- It is also used for prophylaxis in children with vesicoureteral reflux (VUR) to prevent recurrent febrile UTIs [ 1 ].
Important Considerations
- Nitrofurantoin should be avoided in infants under 4 months due to the risk of hemolytic anemia [ 1 ].
- Local antimicrobial susceptibility patterns should be considered when selecting empirical antimicrobial therapy [ 1 ].
From the FDA Drug Label
Clostridium difficile-associated diarrhea: Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including nitrofurantoin, and may range in severity from mild diarrhea to fatal colitis.
- Macrobid (Nitrofurantoin) is an antibiotic because it is included in the list of antibacterial agents that can cause Clostridium difficile-associated diarrhea (CDAD) 2.
From the Research
Definition and Classification of Macrobid (Nitrofurantoin)
- Macrobid, also known as Nitrofurantoin, is classified as an antibiotic 3, 4, 5, 6, 7.
- It is a broad-spectrum bactericidal antibiotic that is effective against a wide range of gram-positive and gram-negative bacteria 4, 5.
Mechanism of Action
- Nitrofurantoin works by interfering with the synthesis of cell wall, bacterial proteins, and DNA of both gram-positive and gram-negative pathogens 4.
- It is converted to highly reactive electrophilic intermediates by bacterial nitroreductases, which attack bacterial ribosomal proteins non-specifically, causing complete inhibition of protein synthesis 7.
Clinical Use
- Nitrofurantoin is primarily used as an oral antibacterial treatment for genitourinary infections, including urinary tract infections (UTIs) 3, 5, 6.
- It is recommended as a first-line antibiotic for the empiric treatment of uncomplicated cystitis in otherwise healthy women 3.
- Nitrofurantoin has also been used for the prophylaxis of recurrent uncomplicated UTIs 3, 5.
Resistance and Efficacy
- Despite its long application, nitrofurantoin has retained good activity against common urinary tract pathogens, including Escherichia coli and Staphylococcus saprophyticus 3.
- The lack of clinically significant bacterial resistance development to nitrofurantoin is likely due to its multiple sites of attack and multiple mechanisms of action 7.
- Recent studies have shown that nitrofurantoin has a good efficacy and tolerability profile, comparable to other standard therapeutic regimens 3, 6.