UTIs can be classified as lower urinary tract infections, including both asymptomatic bacteriuria (ASB) or acute cystitis (AC), and upper urinary tract Exposure to nitrofurantoin at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring
Author links open overlay panel Ori Goldberg MD, MPH 1 2, Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study
D
Pertinent Points: - Nitrofurantoin dispensed in the first trimester was not associated with an increased risk of major malformations
Asymptomatic bacteriuria occurs in 2-10% of pregnancies and up to 30% will develop UTI if left untreated 5 No increased risk for secondary adverse pregnancy outcomes was observed when compared with the disease comparison group
02-1
Prescribe nitrofurantoin with caution to women with: Peripheral neuropathy or susceptibility to peripheral neuropathy, including folate deficiency — treatment should be stopped at the first signs of neural involvement (paraesthesiae)
This risk is reduced by 70 to 80 percent if bacteriuria is eradicated (see 'Rationale for treatment' below)
As with all patients, antibiotics should Pregnancy Category B "Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women
3 The authors of a meta-analysis of studies in humans did not find evidence of harmful effects in pregnancy, but they were cautious about drawing conclusions View nitrofurantoin information, including dose, uses, side-effects, renal impairment, pregnancy, breast feeding, contra-indications and monitoring requirements
TMP/SMX should be used during the 1st beta-lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy
g
Exposure to nitrofurantoin was not associated with increased risk of major malformations in general (adjusted OR = 0
but nitrofurantoin is generally considered to be safe during all 3 trimesters of pregnancy
The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed
It is important to note that most of these studies have been observational in Prior warnings only address near-term pregnancy
There is insufficient data to recommend any specific type of treatment regime in symptomatic UTI in pregnancy
One particular concern when using nitrofurantoin during pregnancy is the risk of hemolytic anemia in the newborn
[UKHSA, 2020], and expert opinion in a review article on UTI in pregnancy [Johnston, 2017]
B (contraindicated at term) Pregnancy Considerations
UTIs are managed more aggressively in pregnant women than in non-pregnant women
Tips For pregnant women: During weeks 0-37 of pregnancy, nitrofurantoin is a category B pregnancy drug
Committee Opinion No
Studies have found that taking it during the last 30 days of pregnancy may raise the risk of infant jaundice after birth
85, 95% CI 0
85, 95% CI 0
22; 95% CI 1
But if you're in your last 2 to 4 weeks of pregnancy, don't take nitrofurantoin (Macrobid); there's a potential risk that this antibiotic can harm an unborn baby during that time
8%]) compared with unexposed women (10,336 of 127,507 [8
No increased risk of hemolytic anemia was found compared with 50-100mg at night
Avoid in last 4 weeks of pregnancy
It works by killing bacteria that cause infection
Nitrofurantoin treatment can stop the unpleasant symptoms of a UTI and may also lower the chance of some pregnancy problems linked to untreated UTI, including
Urinary tract infection (UTI) is considered to be a major problem in pregnant women [1,2,3]
This antibiotic can affect glutathione reductase activity and hence can
For instance, using Nitrofurantoin in pregnancy may come with certain conditions, even though the medication is generally safe with rare, severe
Nitrofurantoin associated with increased risk of 4 birth defects: anophthalmia or microphthalmos (OR 3
While no association was found between fetal exposure to nitrofurantoin and major malformation in cohort studies, there was a slight but significant teratogenic risk in
Exclusion criteria were prenatal exposure to both pivmecillinam and nitrofurantoin or inability to determine exposure to medications in pregnancy
Given this risk profile, use of nitrofurantoin is best limited to the second trimester
Read this article to learn more about using Nitrofurantoin during pregnancy and breastfeeding
beta-lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy
Risk of peripheral neuropathy; antibacterial efficacy depends on renal secretion of the drug into urinary tract
717: Sulfonamides, Nitrofurantoin, and Risk of Birth Defects
The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed
Six malformed children were born in the exposed group, giving a standardized nonsignificant relative risk of 1
The drug has gonadotoxic effects in male and female rats and mice and teratogenic
It is also one of the most prevalent infections during pregnancy, being diagnosed in as many as 50–60% of all gestations []
5 Up to 10% of pregnancies are affected by bacteriuria, making it one of the most common pregnancy complications
One particular concern when using nitrofurantoin during pregnancy is the risk of hemolytic anemia in the newborn
prescribe nitrofurantoin 100 mg modified-release twice a day for 7 days
B (contraindicated at term) Pregnancy Considerations
Urinary tract infections (UTIs) occur commonly during pregnancy
Long-term use has been associated with an increased risk of serious side effects, including potentially fatal lung conditions