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Thread: Long term low dose nitrofurantoin

  1. #1

    Long term low dose nitrofurantoin

    I have been prescribed long term low dose (50 mg/day) nitrofurantoin to help manage recurrent klebsiella aerogenes. First I had a short course of a stronger antibiotic, then a several months long course of nitrofurantoin.

    Is this likely to have effect on bowels? I have had a lot of problems with antibiotic-caused diarrhea, but for more powerful antibiotics.

  2. #2
    This is a really low dose of nitrofurantoin
    Make sure your kidney function is within normal limits also with a long term dose of this antibiotic
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    I've been taking nitrofurantoin 100 mg/day for the past 6 years or so. Before I was started on it I was getting hospitalized 1-2 times per year when my UTI got out of control and probably on oral antibiotics 3-4 additional times per year. Haven't been hospitalized since and the two episodes I've had over the past six years that I thought were due to a UTI turned out to be culture negative (so probably prostatitis or something else).

    I'm not sure what a "normal" long term dose is. Some random urgent care doc started me on this when I had a UTI and suggested I stay on it, subsequent PCPs have been nice enough to continue it and I feel like it's working well for me.

    I take it at night because nitrofurantoin only works because it's excreted in concentrated form in the urine, so I figure your urine is most concentrated at night, and in your bladder the longest at night (assuming intermittent catheterization and a reasonable bladder volume), so it makes sense to me to me to take it a night.

    Nitrofurantoin is a weak antibiotic and doesn't really get concentrated enough anywhere in the body to kill any bugs until it's in the urine, so it shouldn't cause GI issues as it's not killing off gut bacteria. Also I don't think nitrofurantoin resistance is a problem from what I've been able to read up on.

    Clearly I'm a bit biased as I feel like it's done me a world of good.

  4. #4
    @funklab thank you for the information and experience.

    You say to take it at night but I was told it was important to take it with food. So I try to take it with a meal, which is usually before I go to bed.

  5. #5
    Nitrofurantoin affects bacteria only in the urinary tract. Your gut flora should not be affected.

    I had kidney stones. Had them removed and took nitrofurantoin 100 mg 1x daily plus potassium citrate ER 15 MEQ 2x daily for about 1 year. No UTIs. Now I take only the potassium citrate daily and nitrofurantoin only as needed. I take 1 dose of nitrofurantoin at the first sign of a UTI symptom (usually stronger spasms). The symptoms usually go away the next day and I stop the nitrofurantoin.

    I know there is a school of thought that says you're supposed to take a full course even if you feel better after the first dose. But there is also a school of thought that says doing that promotes colonization. Tried both approaches and the single dose approach works better for me.

  6. #6
    Join Date
    Nov 2009
    central plains of Canada
    I've been on 50mg/day for many years. Changed my life.

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