Urinary Tract Infections
Nitrofurantoin is used in the treatment of initial or recurrent urinary tract infections (UTIs) caused by susceptible gram-positive bacteria including enterococci and Staphylococcus aureus and gram-negative bacteria including Escherichia coli and some strains of Klebsiella, Enterobacter, and Proteus. The manufacturer states that dual-release capsules of nitrofurantoin are indicated for use only in the treatment of acute UTIs (cystitis) caused by susceptible E. coli or S. saprophyticus. The drug is not indicated for the treatment of pyelonephritis or associated renal cortical or perinephric abscesses. Nitrofurantoin is not effective in systemic bacterial infections and has no effect on bacteria in blood or tissues outside the urinary tract. As with other urinary antibacterial agents, the follow-up cure rate with nitrofurantoin in recurrent infections is low.
Prior to and during nitrofurantoin therapy, urine should be cultured and in vitro susceptibility tests performed. As with all urinary tract infections, follow- up cultures should be performed to determine if the infection has been eradicated.