Nitrofurantoin is an antibacterial medication used to treat urinary tract infections, but it is not as effective for kidney infections. It is taken by mouth.Common side effects include nausea, loss of appetite, diarrhea, and headaches. Rarely numbness, lung problems, or liver problems may occur. It should not be used in people with kidney problems. While it appears to be generally safe during pregnancy it should not be used near delivery. While it usually works by slowing bacterial growth, it may result in bacterial death at the high concentrations found in urine.Nitrofurantoin was first sold in 1953. It is on the World Health Organizations List of Essential Medicines. It is available as a generic medication. In 2019, it was the 192nd most commonly prescribed medication in the United States, with more than 2 million prescriptions. Medical uses
Current uses include the treatment of uncomplicated urinary tract infections (UTIs) and prophylaxis against UTIs in people prone to recurrent UTIs.Increasing bacterial antibiotic resistance to other commonly used agents, such as trimethoprim/sulfamethoxazole and fluoroquinolones, has led to increased interest in using nitrofurantoin. 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 of pyelonephritis, prostatitis, and intra-abdominal abscess, because of extremely poor tissue penetration and low blood levels.
Therapy is directed at serious symptoms and the underlying disorder, if any is found. Keep in mind that the idiopathic variety of cold agglutinin disease is generally a benign disorder with prolonged survival and spontaneous exacerbations and remissions in the course of the disease. Acute post infectious syndromes usually resolve spontaneously. Anemia is generally mild. Only patients who have serious symptoms related to anemia or have a Raynaud type syndrome that constitutes a threat to life or quality of life require active therapy. The presence of an associated malignancy requires specific therapy. Cold agglutinin disease is so uncommon in children that no specific recommendations for therapy are available. Intravenous immunoglobulin (IVIG) was used successfully in an infant with IgA-associated autoimmune hemolytic anemia. Splenectomy
Splenectomy is usually ineffective for the treatment of cold agglutinin disease because the liver is the predominant site of sequestration. However, if the patient has splenomegaly, then the disease may respond to splenectomy. More importantly, a lymphoma localized to the spleen may only be found after splenectomy. Diet and activity
Patients with cold agglutinin disease should include good sources of folic acid, such as fresh fruits and vegetables, in their diet. Activities for these individuals should be less strenuous than those for healthy people, particularly for patients with anemia. Jogging in the cold could be very hazardous because of the added windchill factor. Consultations
A hematologist-oncologist working in collaboration with a blood banker is helpful in complicated cases of cold agglutinin disease.