What is the role of nitrofurantoin in the treatment of urinary tract infection (UTI) during pregnancy?

Updated: Oct 08, 2019
  • Author: Raisa O Platte, MD, PhD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Nitrofurantoin is safe and effective; however, poor tissue penetration has limited its use in pyelonephritis. In the past, nitrofurantoin was completely avoided in the third trimester because of hemolytic effects on the newborn. Currently, restriction of this agent is limited to the last several weeks of pregnancy. Use during this period can cause hemolytic anemia in the fetus or neonate as a consequence of their immature erythrocyte enzyme systems (glutathione instability). Nitrofurantoin is also safe and effective for once-daily prophylactic therapy during pregnancy. [29]


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