Niftas (nitrofurantoin macrocrystals) is an antibiotic treatment useful in preventing or combating urinary tract infections (UTIs) or bladder infections.

While Niftas is a potent antibiotic, it concentrates in the bladder. This makes it largely ineffective against bacteria elsewhere in the body, including the kidneys. It is effective on bladder or UTI infections caused by common bacteria, including E. coli and several Staphylococcus and Streptococcus species.

Ideally the particular bacteria and its susceptibility to Niftas will be identified by a doctor prior to initiating treatment; though common, the above-listed bacteria aren't the only bacteria that can cause bladder or UTI infections. Niftas isn't effective against all types bacteria, and some strains of bacteria have developed resistance to Niftas. Similarly Niftas will have no effect on viral or fungal infections.

Niftas is appropriate for all ages, though young children will require modified dosing.

There is conflicting evidence as to the safety of Niftas on unborn or nursing babies. Pregnant or breastfeeding mothers should discuss potential risks with a doctor.

Niftas comes in tablets, typically taken four times per day. Food or milk should be taken with each dose to improve absorption and reduce gastrointestinal side effects.

Fighting Infection with Niftas

In treating infection, dosage depends on the severity of the infection and, to some extent, on patient weight. Likewise duration of treatment may vary; one week is sufficient in most cases, but sometimes it will take longer. Some improvement is usually noticed within a day or two of starting treatment, with significant alleviation of pain, discomfort, and other UTI symptoms.

General guidelines for otherwise healthy adults:

• 50 to 100 mg should be taken four times per day, spaced apart as evenly as possible.
• Food or milk should be consumed with each dose to aid with absorption.
• Treatment should continue for at least one week.
• Treatment should continue for three days after the infection has cleared up.

In pediatric patients dosage depends on weight; as a general rule, 5 mg of Niftas per kg of weight per day. As with adults, the total dose should be divided into four smaller doses, taken at evenly-spaced intervals throughout the day.

In most cases a week will fully heal the infection. As a general rule treatment should continue for three days following the resolution of all symptoms; even when symptoms are gone, there may be lingering bacteria.

If there is little or no improvement after a week of taking Niftas a doctor should be consulted; it may not be a bacterial infection, or the bacteria may have developed resistance.

Preventing Infection

Individuals who are at risk of acquiring a UTI, or who are simply prone to recurring infections, use Niftas to prevent an infection from taking hold. As a preventive measure treatment is much simpler:

• Adults should take 50 to 100 mg once per day, typically at bedtime.
• Children should be given 1 mg per kg of weight per day, at bedtime.
• Treatment may continue for as long as necessary, but there are risks associated with long-term use.

Again each dose should be taken with food or milk.

Potential Complications

Patients taking Niftas long term---more than a couple of consecutive weeks, as is often the case in preventive treatment---are at increased risk of severe side effects. The most serious is pulmonary (lung) complications; though rare, affecting just 1 in 5000 patients, this effect can be permanent. The risk of pulmonary complications are slightly higher in women and elderly patients.

All patients taking Niftas for more than a couple of weeks should be alert for any change in lung function, including:

• Frequent coughing
• Chest pain
• Difficulty breathing
• Any other change in breathing/lung function

Regular doctor checkups will also help monitor for developing complications.

Most patients experience only mild side effects from Niftas, similar to those experienced while taking any antibiotic. Most common side effects include:

• Abdominal discomfort
• Nausea
• Vomiting
• Appetite loss
• Headache
• Diarrhea

The above symptoms are not cause for concern unless severe, and will reverse when treatment ends.

Niftas may cause the urine to be brown. This is normal and not cause for concern.