The mechanism of action of nitrofurantoin is unique and complex. The drug works by damaging bacterial DNA, since its reduced form is highly reactive.This is made possible by the rapid reduction of nitrofurantoin inside the bacterial cell by flavoproteins (nitrofuran reductase) to multiple reactive intermediates that attack ribosomal proteins, DNA,respiration, pyruvate metabolism and other macromolecules within the cell. Nitrofurantoin exerts greater effects on bacterial cells than mammalian cells because bacterial cells activate the drug more rapidly. It is not known which of the actions of nitrofurantoin is primarily responsible for its bactericidal activity. The broad mechanism of action for this drug likely is responsible for the low development of resistance to its effects, as the drug affects many different processes important to the bacterial cell.

  Application                                      

 Nitrofurantoin has been available for the treatment of urinary tract infections (UTIs) since 1953. Its current uses include the treatment of uncomplicated UTIs and prophylaxis against UTIs in people prone to recurrent UTIs.

Increasing bacterial antibiotic resistance to other commonly used agents, such as fluoroquinolones and trimethoprim/sulfamethoxazole, has led to increased interest in using nitrofurantoin.Several trials comparing nitrofurantoin to other commonly used agents have shown this drug results in similar cure rates for uncomplicated UTIs.The efficacy of nitrofurantoin in treating UTIs combined with a low rate of bacterial resistance to this agent makes it one of the first-line agents for treating uncomplicated UTIs as recommended by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases.

Nitrofurantoin is not recommended for the treatment ofpyelonephritis,prostatitis and intra-abdominal abscess,because of extremely poor tissue penetration and low blood levels.

It is used in the treatment of infections caused by these organisms.

  Specification