Nitrofurantoin is an antibiotic used to treat or prevent certain bacterial infections in the body. It is commonly prescribed to pregnant women in the third trimester, as it is considered safe for both mother and unborn child. However, as with all medications, it is important to consult with a doctor before taking any medication during pregnancy. In this blog post, we will explore the use of nitrofurantoin in the third trimester of pregnancy, looking at the potential risks and benefits associated with the medication. We will also discuss what to expect when taking nitrofurantoin in pregnancy, as well as possible side effects and precautions. Finally, we will provide some recommendations for pregnant women who are considering taking nitrofurantoin during their third trimester.
Nitrofurantoin is still classified by the US Food and Drug Administration as a Category B drug (probably safe). It is still advised to avoid using nitrofurantoin in pregnant patients who are about to give birth, according to the Canadian Compendium of Pharmaceuticals and Specialties (2007);9 until more information is available, it would be wise to abide by this recommendation.
In a recent teaching case report published in the CMAJ, Aneez Mohamed and colleagues skillfully describe a significant side effect of nitrofurantoin therapy that could have happened even if the patient had not been pregnant. However, given that nitrofurantoin use is contraindicated in pregnant patients whose labor may be on the verge of beginning, the complication in this instance should have been avoided.
Pregnant women frequently use nitrofurantoin to treat urinary tract infections. Studies using animal models haven’t revealed a clear issue with fetal exposure to this antibiotic. 3 Despite the fact that there was no proof of harmful effects during pregnancy, the authors of a meta-analysis of human studies were cautious about drawing any conclusions due to the limited amount of data available. 4.
Pregnant women’s use of nitrofurantoin is still a concern for a number of reasons. This antibiotic can impair glutathione reductase activity, which can lead to hemolytic anemia (similar to the issues it can bring about in patients with insufficient glucose-6-phosphate dehydrogenase). Hemolytic crises have been reported in patients who are newborns and fetuses who appear to be particularly vulnerable to this effect on glutathione reductase activity. 5,6 Additional data connects craniosynostosis to fetal nitrofurantoin exposure and medications with related chemical structures. 7,8.
Are there any alternatives to taking nitrofurantoin in pregnancy?
Possibly. Although other antibiotics can treat UTI, nitrofurantoin may be more effective. A physician or midwife will be able to explain why a specific antibiotic is suggested as the best course of action.
Will I or my baby need extra monitoring?
Women are invited for a very thorough scan as part of routine antenatal care in the UK at around 20 weeks of pregnancy to check the baby’s development. No further monitoring is required for women taking nitrofurantoin.
How do you treat a UTI in the third trimester?
Which antibiotics should be avoided during third trimester?
Are antibiotics safe during third trimester of pregnancy?
What is nitrofurantoin used for in pregnancy?