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Macrobid For UTI Treatment: Pros And Cons

Since 1953 doctors have been successfully using Macrobid for UTI treatment and prevention in adults, children, and pregnant women (not for late pregnancy). Macrobid, Macrodantin, and Furadantin are the brand names of nitrofurantoin in the US.

Good news that there is no known link between this medication and the development of resistant organisms.

Therefore Macrobid for UTI is a great candidate for the treatment of infections caused by multidrug-resistant bacteria. It works best against UTIs caused by E. coli in the early stages and is not that effective against Klebsiella.

However, Nitrofurantoin is not effective for kidney infection treatment because of extremely poor tissue penetration and low blood levels.

A lesser risk to develop an antibiotic-resistant bacteria

When you take a pill your small intestines quickly absorb nitrofurantoin, 75% of the dose is quickly metabolized by the liver, and 25% of the dose is excreted in the urine.

The antibiotic enters the bacterial cells and damages the genetic material (DNA) of the offending bacteria, affects respiration, certain metabolic processes, and other macromolecules within the bacterial cell and eventually leads to the death of the bacteria.

This means that the bacteria cannot reproduce and repair themselves. Since the mechanism of action is unique and complex it is harder for the bacteria to develop resistance.

Minor side-effects

How soon will nitrofurantoin (Macrobid) work?

  • I felt better within an hour. You should definitely feel better within the first 8-12 hours. However, remember to finish all pills even if you no longer have any symptoms
  • Check out these tips when treating UTI with antibiotics. 

Minimal effect on your gut’s microbiome

Have you heard that antibiotics kill good and bad gut bacteria? This is, of course, a generalization, a pretty broad statement. Your body has over 3000 types of beneficial bacteria residing in various organs, skin, and membranes.

The unique composition of your good and bad bacteria called “microbiota” or “microbiome”. However, the field of study that focuses on researching how your microbiota composition affects your health is relatively new.

One of the recent clinical studies looked at how nitrofurantoin affects human intestinal microbiota (this did not include vaginal microbiota).

While the study had several limitations early findings demonstrated that a 100 mg dose of nitrofurantoin daily has minimal impact on the aerobic intestinal microbiota.

In fact, nitrofurantoin had an effect of reducing the proportion of Clostridium, some members of which are pathogenic, and increasing Faecalibacterium, considered to have numerous beneficial effects for health through protection against pathogen invasion, modulation of immune system and reduction of cancer progression

It is relatively safe for UTI prevention

In 2014 a clinical study tested nitrofurantoin alongside with D-Mannose (read: What’s D-Mannose powder and how it works) for long-term UTI prevention effectiveness.

A group of 308 female patients with a history of recurrent UTI and no other significant health issues was randomly allocated to three groups after completing antibiotic treatment of acute cystitis.

The first group was taking 2 g of D-mannose powder in 200 ml of water daily for 6 months, the second group received 50 mg Macrobid for UTI prevention daily, and the third did not receive anything to prevent infection from recurring.

As a result, the patients in the D-Mannose group and nitrofurantoin group had a significantly lower risk of recurrent UTI episode during prophylactic therapy compared to patients who were receiving no preventive treatment.

Patients in both groups did not have any significant side effects when taking D-Mannose and nitrofurantoin during this 6 month period.

Concerns with long-term use

Although relatively rare, nitrofurantoin is one of the commonest causes of drug-induced pulmonary disease, which can be very serious and even life-threatening.

It is important to make sure that if you or your loved ones are taking nitrofurantoin (Macrobid) for UTI prevention your physician monitors patient’s lung function regularly.

If you have noticed any problems with lung function, talk to your physician to discontinue nitrofurantoin. Therefore, especially if you are taking this antibiotic for a prolonged period of time to prevent UTIs, pay attention to the following symptoms:

  • Ongoing shortness of breath
  • Fever
  • Chills
  • A cough
  • Recurrent chest infections
  • Chest pain
  • A headache
  • Back pain

In some cases, especially with prolonged usage of nitrofurantoin, severe and irreversible health issues could happen such as peripheral neuropathy. Please read comments below of women who suffer from serious debilitating side-effects associated with prolonged usage of nitro.

Read next:


  1. D-mannose powder for prophylaxis of recurrent urinary tract infections in women: a randomized clinical trial.
  2. Nitrofurantoin-induced lung disease and prophylaxis of urinary tract infections.
  3. Collateral damage from oral ciprofloxacin versus nitrofurantoin in outpatients with urinary tract infections: a culture-free analysis of gut microbiota.

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