Gleckman R, Alvarez S, Joubert D W
Am J Hosp Pharm. 1979 Mar;36(3):342-51.
Mechanism of action, antimicrobial spectrum, pharmacology, adverse reactions and therapeutic uses of nitrofurantoin, a broad-spectrum antimicrobial agent, are discussed. The frequency and potential severity of reactions attributed to nitrofurantoin, plus its inability to achieve therapeutic blood concentrations, relegate this drug to a position of secondary importance. Nitrofurantoin compares favorably with other standard agents for the therapy of acute and recurrent urinary tract infections in women which may be caused by susceptible organisms, and it is an effective chemoprophylactic agent for patients with recurrent urinary tract infections. The compound has no apparent adverse effects on the developing fetus and can be used in pregnant women. This is not sanctioned by the package insert, however. Nitrofurantoin should not be administered when the possibility of bacteremia exists, as the drug does not achieve therapeutic serum levels when administered orally. Nitrofurantoin is contraindicated for patients with renal insufficiency. The value of this compound for men with acute urinary tract infection, recurrent urinary tract infection, acute bacterial prostatitis or chronic bacterial prostatitis has not been established. There are no indications for prescribing parenteral nitrofurantoin.
讨论了广谱抗菌剂呋喃妥因的作用机制、抗菌谱、药理学、不良反应及治疗用途。归因于呋喃妥因的反应频率和潜在严重程度，加上其无法达到治疗性血药浓度，使该药物处于次要地位。在治疗可能由易感微生物引起的女性急性和复发性尿路感染方面，呋喃妥因与其他标准药物相比具有优势，并且它是复发性尿路感染患者的有效化学预防剂。该化合物对发育中的胎儿没有明显不良影响，可用于孕妇。然而，药品说明书未批准此用法。当存在菌血症的可能性时，不应使用呋喃妥因，因为口服给药时该药物无法达到治疗性血清水平。呋喃妥因对肾功能不全患者禁用。该化合物对患有急性尿路感染、复发性尿路感染、急性细菌性前列腺炎或慢性细菌性前列腺炎的男性的价值尚未确定。没有静脉注射呋喃妥因的用药指征。
