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Macrodantin (nitrofurantoin macrocrystals) is an antibiotic used to treat or prevent bacterial infection in the bladder or urinary tract. It is effective against a wide range of bacteria, but because it concentrates in the bladder and has poor penetration elsewhere in the body, it is not very effective in other applications. It can be used in all ages and it also used in veterinary medicine.

There is some antibiotic resistance to Macrodantin but it is not as widespread as many other types of antibiotics. To help prevent further resistance from developing it's important to complete treatment with this or any other antibiotic, antifungal, or antiviral medication even if symptoms clear up.

Using Macrodantin to Treat Infections

Macrodantin is effective at treating infection of the bladder or urinary tract. It is useful against a range of bacteria commonly associated with such infections, including E. coli and several Staphylococcus and Streptococcus species.

This particular medication provides little benefit against infections in the kidneys or elsewhere in the body. It will not help with fungal or viral infections.

To treat infection in 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.

Dosage depends on both the severity of the infection and 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. If there is little or no improvement after a week of taking Macrodantin a doctor should be consulted; it may not be a bacterial infection.

In younger patients dosage depends on weight; as a general rule, 5 mg of Macrodantin 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.

Using Macrodantin to Prevent Infection

Macrodantin is also used to prevent infection in patients at risk of acquiring an infection or who are simply prone to recurring infections. 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.
• Food or milk should be consumed with each dose to aid with absorption.
• Treatment may continue for as long as necessary, but there are risks associated with long-term use.

Though very rare---about 1 in 5000 patients---some individuals experience pulmonary (lung) complications if taking Macrodantin long-term. The risk is slightly higher in women and slightly higher in elderly patients. Symptoms are not necessarily noticeable until serious damage has been done, which may or may not be reversible. Patients using Macrodantin for more than a couple weeks should be alert for any change in lung function---such as unexplained frequent coughing, chest pain, difficulty breathing, or any other changes---and should attend regular doctor checkups to monitor for developing complications.

Side Effects

Most patients experience only mild side effects from Macrodantin, 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.

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

There is conflicting evidence as to the safety of Macrodantin on unborn or nursing babies. Pregnant or breastfeeding mothers should discuss potential risks with a doctor; in most places safer alternatives will be readily available.