Editing Infections: Antibiotics (section)

===Nitrofurantoin===
*'''Effective against common uropathogens'''; '''not effective against Pseudomonas and Proteus'''
*Rapidly excreted in the urine but '''does not obtain therapeutic levels in most body tissues. Therefore, not useful for upper tract and complicated infections.'''
*'''Minimal effects on the resident bowel and vaginal flora''' and has been used effectively in prophylactic regimens
*Acquired bacterial resistance is exceedingly low
*'''Pregnancy'''
**'''2017 American College of Obstetricians and Gynecologists recommendations'''§''':'''
***'''First trimester'''
****Consider and discuss with patients the benefits as well as the potential unknown risks of teratogenesis and fetal and maternal adverse reactions.
****'''Prescribing sulfonamides or nitrofurantoin in the first trimester is still considered appropriate when no other suitable alternative antibiotics are available.'''
***'''Second and third trimesters'''
****'''Can be used as first-line agents''' for the treatment and prevention of urinary tract infections and other infections caused by susceptible organisms.
***Contraindicated in patients with glucose-6-phosphate dehydrogenase deficiency, or in pregnant women identified to be at risk of this condition.
**'''CW12 page 1186-1187'''
***'''First and second trimester'''
****'''May be used safely in patients without glucose-6-phosphate dehydrogenase deficiency'''
***'''Third trimester'''
****'''Should be discontinued at 35 weeks''' because of an increased risk of hemolytic anemia in the neonate.