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- Nitrofurantoin vs. Bactrim: What's the difference?
- What are nitrofurantoin and Bactrim?
- What are the side effects of nitrofurantoin and Bactrim?
- What is the dosage of nitrofurantoin vs. Bactrim?
- What drugs interact with nitrofurantoin and Bactrim?
- Are nitrofurantoin and Bactrim safe to use while pregnant or breastfeeding?
Nitrofurantoin vs. Bactrim: What's the difference?
- Nitrofurantoin and Bactrim (sulfamethoxazole and trimethoprim) are antibiotics used to treat urinary tract infections (UTIs).
- Bactrim is also used to treat other types of bacterial infections including flares of chronic bronchitis due to bacteria, middle ear infections, for prevention of infections due to pneumococcus in organ transplant recipients, for the treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and for prevention of Toxoplasma encephalitis in patients with AIDS.
- Brand names of nitrofurantoin include Macrobid, Macrodantin, and Furadantin.
- Side effects of nitrofurantoin and Bactrim that are similar include headache, rash, nausea, vomiting, loss of appetite, and diarrhea.
- Side effects of nitrofurantoin that are different from Bactrim include itching, change in urine color, and abdominal pain.
- Side effects of Bactrim that are different from nitrofurantoin include dizziness and lethargy.
What are nitrofurantoin and Bactrim?
Nitrofurantoin is an antibiotic used to treat urinary tract infections (UTIs) caused by several types of bacteria including E. Coli, Enterobacter cystitis, Enterococcus, Klebsiella, and Staphylococcus aureus. Nitrofurantoin interferes with the production of bacterial proteins, DNA, and cell walls. Bacteria cannot survive without a cell wall or multiply without DNA. Three forms of nitrofurantoin are available: Furadantin, a microcrystalline form; Macrodantin, a macrocrystalline; and Macrobid, a sustained release form of macrocrystalline used twice daily. The macrocrystalline form is more slowly absorbed than the microcrystalline form and is useful for patients who cannot tolerate the microcrystalline form.
Bactrim (sulfamethoxazole and trimethoprim) is a combination of an antibacterial sulfonamide (a "sulfa" drug) and a folic acid inhibitor. By combining both drugs, two important steps required in the production of bacterial proteins are interrupted, and the combination is more effective than either drug alone. Bactrim is used to treat bacterial infections including urinary tract infections, flares of chronic bronchitis due to bacteria, middle ear infections, for prevention of infections due to pneumococcus in organ transplant recipients, for the treatment or prevention of Pneumocystis carinii pneumonia, chancroid, and prevention of Toxoplasma encephalitis in patients with AIDS.
What are the side effects of nitrofurantoin and Bactrim?
Common side effects of nitrofurantoin include:
The macrocrystalline form (Macrodantin) appears to cause less stomach upset. Stomach upset also can be minimized by using a lower dose or by taking nitrofurantoin with food or milk.
Possible serious side effects include:
Nitrofurantoin can cause serious lung injury. The reaction can occur within hours of the start of treatment if the patient has previously received nitrofurantoin, or within a few days of starting nitrofurantoin for the first time. Symptoms include:
In other persons, lung injury may occur after approximately a month of treatment. Symptoms include:
- Difficulty breathing
- Rapid breathing
Fortunately, the symptoms usually resolve within a week if the medication is stopped. In other individuals, lung injury may not develop until after several months or years of therapy. Unless it is recognized and treated, this delayed lung injury can result in permanent lung damage that remains even after the drug is stopped.
Nitrofurantoin can also cause damage to the sensory nerves of the arms and legs (peripheral neuropathy), which can cause tingling in the extremities. The condition can become severe and is more likely to occur in people with diabetes, vitamin B deficiency, or general debilitation.
Reduced red blood cell count (anemia) by breaking red blood cells (hemolytic anemia) can occur from nitrofurantoin. This reaction occurs most frequently in persons with a deficiency of an enzyme called glucose-6-phosphate dehydrogenase that is very important to the survival of red blood cells.
Treatment with nitrofurantoin can cause urine to change color to a dark yellow or brown.
Common side effects of sulfamethoxazole/trimethoprim are:
Other side effects include:
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What is the dosage of nitrofurantoin vs. Bactrim?
- The recommended adult dose for treating urinary tract infections is 50-100 mg 4 times daily (Macrodantin, Furadantin) or 100 mg every 12 hours (Macrobid) for 7 days or for 3 days after obtaining sterile urine.
- Nitrofurantoin can be taken with or without meals. Taking it with meals increases its absorption into the body.
- The suspension can be mixed with water, milk, juice, or infant formula.
- It also is used once a day (or in some children, twice daily) to prevent urinary tract infections.
- It should not be used in persons with poor kidney function.
- The recommended adult dose for urinary tract infections is one double strength tablet (Bactrim DS, Septra DS) or two single strength tablets every 12 hours for 10 to 14 days.
- Flares of chronic bronchitis are treated with a similar regimen for 14 days.
- Bactrim should be taken with 6 to 8 ounces of liquid to prevent crystals from forming in the urine. Persons with advanced kidney disease may require lower doses.
What drugs interact with nitrofurantoin and Bactrim?
- High doses of probenecid (Benemid) or sulfinpyrazone (Anturane) can partially block the kidneys' elimination of nitrofurantoin. This can increase the blood concentrations of nitrofurantoin and the risk of toxicity from nitrofurantoin.
- Concomitant administration of a magnesium trisilicate antacid may decrease the absorption of nitrofurantoin, reducing the effectiveness of nitrofurantoin.
- Nitrofurantoin may reduce the activity of live tuberculosis vaccine (BCG vaccine) and live typhoid vaccine. In laboratory tests, nitrofurantoin reduced the effect of quinolone antibiotics, for example, norfloxacin (Noroxin). Therefore, nitrofurantoin should not be combined with quinolone antibiotics.
Sulfonamides such as sulfamethoxazole can increase the metabolism (breakdown and elimination) of cyclosporine (causing loss of effectiveness of cyclosporine), and can add to the kidney damage caused by cyclosporine.
Blood levels of phenytoin (Dilantin) may be increased by treatment with Bactrim. This may lead to side effects associated with phenytoin (Dilantin, Dilantin-125) such as dizziness, and reduced attention.
Anemia, due to a reduction in folic acid, can occur in persons receiving Bactrim in combination with:
- valproic acid (Depakote, Depakote ER, Depakene, Depacon, Stavzor),
- methotrexate (Rheumatrex, Trexall),
- triamterene, or
Increased blood levels of potassium may occur when Bactrim is combined with ACE inhibitors.
Are nitrofurantoin and Bactrim safe to use while pregnant or breastfeeding?
Although there are no adequate studies of nitrofurantoin in pregnant women, many women have safely used it during pregnancy. However, nitrofurantoin should not be used near the time of delivery (38-42 weeks gestation) since it interferes with the immature enzyme systems in newborns' red blood cells, damaging the cells and resulting in anemia.
Use of sulfonamides may cause bilirubin to be displaced from proteins in the infant's blood. Displacement of bilirubin can lead to jaundice and a dangerous condition called kernicterus in the infant. For this reason, Bactrim should not be used near term (late in pregnancy) among women.
Bactrim should not be used by nursing mothers because sulfamethoxazole is excreted in breast milk and can cause kernicterus.
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Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency, and frequency. Treatment involves a course of antibiotics.
Middle Ear Infection (Otitis Media)
Middle ear infection (otitis media) is inflammation of the middle ear. There are two forms of this type of ear infection, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Babies, toddlers, and children with a middle ear infection may be irritable, pull and tug at their ears, and experience numerous other symptoms and signs. Treatment depends upon the type of ear infection.
Staph (Staphylococcus) Infection
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Pneumonia is inflammation of the lungs caused by fungi, bacteria, or viruses. Symptoms and signs include cough, fever, shortness of breath, and chills. Antibiotics treat pneumonia, and the choice of the antibiotic depends upon the cause of the infection.
Bronchitis is inflammation of the airways in the lung. Acute bronchitis is short in duration (10-20 days) in comparison with chronic bronchitis, which lasts for months to years. Causes of acute bronchitis include viruses and bacteria, which means it can be contagious. Acute bronchitis caused by environmental factors such as pollution or cigarette smoke is not contagious. Common symptoms for acute bronchitis include nasal congestion, cough, headache, sore throat, muscle aches, and fatigue. Acute bronchitis in children also my include runny nose, fever, and chest pain. Treatment for acute bronchitis are OTC pain relievers, cough suppressants (although not recommended in children), and rest. Infrequently antibiotics may be prescribed to treat acute bronchitis.
Is a Staph Infection Contagious?
A staph infection is caused by the bacteria Staphylococcus aureus. Staph can cause boils, food poisoning, cellulitis, toxic shock syndrome, MRSA, and various other illnesses and infections. Most staph infections are transmitted from person to person.
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Bacteria such as E. coli or Pseudomonas can cause a urinary tract infection (UTI). The incubation period for a UTI ranges from three to eight days.
Urinary Tract Infection in Adults
Second Source article from Government
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Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least 3 months, 2 years in a row. Causes of chronic bronchitis include cigarette smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
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Urinary Tract Infections in Children
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Toxoplasmosis (toxo) is a parasitic infection that causes flu-like symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Toxoplasmosis can be contracted by touching the hands to the mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces. Toxoplasmosis can also be contracted by eating raw or partly cooked meat, especially pork or lamb, or touching the hands to the mouth after contact with raw or undercooked meat
Emphysema, Chronic Bronchitis, and Colds
If you have a COPD such as emphysema, avoiding chronic bronchitis and colds is important to avoid a more severe respiratory infection such as pneumonia. Avoiding cigarette smoking, practice good hygeine, stay away from crowds, and alerting your healthcare provider if you have a sinus infection or cold or cough that becomes worse. Treatment options depend upon the severity of the emphysema, bronchitis, or cold combination.
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