- Bacterial Infections 101 Pictures Slideshow
- Take the Tummy Trouble Quiz
- Hepatitis C Slideshow Pictures
- 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:
Latest Medications News
Daily Health News
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.
Subscribe to MedicineNet's General Health Newsletter
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, middle ear infections, for prevention of infections in organ transplant recipients, for the treatment or prevention of infections in patients with AIDS.
Multimedia: Slideshows, Images & Quizzes
HIV & AIDS Quiz: HIV Testing & Symptoms
Now, more than ever, you should know about HIV/AIDS, especially its causes, symptoms treatments, and complications. Take the...
Ear Infection Quiz: Test Your Medical IQ
Is it possible to prevent ear infections? Take the Ear Infection (Otitis Media) Quiz to learn the risks, causes, symptoms and...
Do I Have Pneumonia? Symptoms & Signs
Pneumonia can be deadly. Take the Pneumonia Quiz on MedicineNet to learn more about this highly contagious, infectious disease....
What happens within the body when a person develops bronchitis? Take this quick quiz to learn the causes, symptoms, treatments,...
Urinary Tract Infection Quiz
How would you know if you had urinary tract infection (UTI)? Take the Urinary Tract Infection in Adult Quiz to learn the causes,...
Picture of Chancroid
A sexually transmitted infection (STI) caused by the bacterium Haemophilus ducreyi. See a picture of Chancroid and learn more...
Picture of Bronchitis
Acute bronchitis usually comes on quickly and gets better after several weeks. See a picture of Acute Bronchitis and learn more...
Picture of Ear
There are three sections of the ear, according to the anatomy textbooks. They are the outer ear, the middle ear, and the inner...
Urinary Tract Infection (UTI) Symptoms, Diagnosis, Medication
Understand urinary tract infection (UTI) through pictures. Our experts describe urinary tract infection symptoms like pelvic...
Ear Infection Symptoms, Causes, and Treatment
Learn about the causes and symptoms of ear infections and how they are diagnosed and treated. Read about treatments such as ear...
Bronchitis Symptoms and Treatments
Is bronchitis contagious? Learn about bronchitis, an inflammation of the lining of the lungs. Bronchitis can be aggravated from...
What Is a Staph Infection? Symptoms, Pictures
Do you know what a staph infection is? Learn about the causes, symptoms, and treatment of staph infections (Staphylococcus...
HIV AIDS Facts: Symptoms and Treatments
What is HIV AIDS (human immunodeficiency virus-acquired immunodeficiency syndrome)? Discover myths and facts about living with...
What Are HIV & AIDS? Symptoms, Treatment, and Prevention
HIV, or human immunodeficiency virus, causes acquired immunodeficiency syndrome, or AIDS. Learn about HIV positive, being HIV...
Related Disease Conditions
Urinary Tract Infection in Adults
Second Source article from Government...
Second Source article from Government...
Pneumonia is inflammation of the lungs caused by fungi, bacteria, or viruses. Symptoms and signs include cough, fever, shortness...
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...
Staph Infection (Staphylococcus Aureus)
Staphylococcus or staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness...
Ear Infection (Otitis Media)
Middle ear infection or inflammation (otitis media) is inflammation of the middle ear. There are two forms of this type of ear...
Toxoplasmosis (toxo) is a parasitic infection that causes flu-like symptoms, swollen lymph nodes, and muscle aches and pains that...
Bronchitis (Acute) Contagoius Symptoms, Causes, Treatment, and Recovery Time
Bronchitis is inflammation of the airways in the lung. Acute bronchitis is is short in duration (10 to 20 days) in comparison...
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...
Chronic Bronchitis (Symptoms, Causes, Treatment, Remedies)
Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a...
Urinary Tract Infections in Children
Urinary tract infections (UTIs) are very common in children. Symptoms and signs include fever and abdominal pain. Associated...
Acquired Immunodeficiency Syndrome
AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci,...
Is a Urinary Tract Infection (UTI) Contagious?
Bacteria such as E. coli or Pseudomonas can cause a urinary tract infection (UTI). The incubation period for a UTI ranges from...
Is E. coli Contagious? (Symptoms and Cure)
E. coli is an infection found worldwide. There are several subtypes of the E. coli species. E. coli spreads from person to...
Is a Staph Infection Contagious?
A staph infection is caused by the bacteria Staphylococcus aureus. Staph can cause boils, food poisoning, cellulitis, toxic shock...
Treatment & Diagnosis
Medications & Supplements
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.