Sinusitis can affect the quality of life of infected people. In addition, such infections can block the nose, cause headaches, and produce overall general discomfort. Nitrofurantoin for sinus infection is a treatment that a surprising number of people believe is effective. This article will explain what this is all about and why this is a misconception.
We’ll highlight the medication, its mode of action, side effects, uses, and why it isn’t suitable to use nitrofurantoin for sinus infections.
What Is Nitrofurantoin?
Nitrofurantoin is a broad-spectrum antibiotic that specializes in dealing with infectious diseases and bacteria of the UT (urinary tract). However, it’s not as effective if the infection is localized within the kidney (more about that very soon).
Although it’s a broad-spectrum antibiotic, nitrofurantoin is especially effective against Escherichia coli or E. coli bacteria, the primary causative organism of urinary tract infections.
What Infections Does Nitrofurantoin Treat?
Nitrofurantoin is primarily used to treat lower urinary tract infections, especially in women, since these infections are more common in females.
Urethras in females are shorter than in men, providing a considerably easier pathway for bacteria to the bladder. Men can also get such infections, but it’s less common.
Nitrofurantoin Dosage Forms
Nitrofurantoin doses will vary depending on age and condition. This drug is administered through the oral route and could be in the form of capsules, tablets, and suspensions.
You can use nitrofurantoin to either treat an existing urinary tract infection or as a precaution to prevent an expected one. Here’s how:
Using Nitrofurantoin as a Treatment
For adults and teenagers: Use 50–100 mg 4 times daily or every 6 hours until the doctor tells you to stop or until the antibiotic course is over.
For children down to 1 Month: Use 5–7 mg per kg of body weight. The doctor usually determines the exact dose and duration.
For infants younger than 1 month, nitrofurantoin is not recommended at this age as it’s potentially dangerous.
Using Nitrofurantoin as Preventive Means
For adults and teenagers: Use 50–100 mg once before bedtime.
For children down to 1 Month: The doctor determines the exact dose and duration.
For infants younger than 1 month: We don’t use nitrofurantoin at this age.
Using Nitrofurantoin Extended-Release Capsules
Nitrofurantoin can be used in the form of extended-release capsules. For example, teenagers of 12+ years and adults may take a 100 mg capsule every 12 hours for 7 days.
Children below 12 years should have their dose adjusted by the doctor depending on their condition and their body weight.
Please remember that the previous scheme isn’t a replacement for the doctor’s prescription. Conditions and requirements are variable, and any improper use of nitrofurantoin can be potentially dangerous.
How Nitrofurantoin Works
The body quickly absorbs nitrofurantoin due to its short half-life (less than an hour). It’s then rapidly excreted in the urine inside the bladder. That’s where the infection-inducing bacteria, mainly E. coli, are present.
Nitrofurantoin then enters the bacteria, and that’s where it gets activated. It then causes instability in the metabolites of the bacteria, disrupting vital intracellular components like DNA and RNA, eventually leading to cellular failure and death of the bacteria.
What Are the Side Effects of Nitrofurantoin?
Much like most drugs in medicine, nitrofurantoin has its fair share of side effects. Some of these side effects are common and tolerable, while others can be serious and require immediate medication alteration.
Common Side Effects
The most common three side effects are nausea, gas build-up, and headaches.
Other side effects include but aren’t limited to:
- Fever
- Mild skin rash
- Itchiness
- Abdominal pain
- Urine discoloration
- Sore throat
- Loss of appetite
- Loss of energy
Serious Side Effects
These side effects are rare and mostly happen due to an allergy to nitrofurantoin or interactions with other drugs, making them less likely to occur as your doctor would know when this drug isn’t appropriate.
However, they have a 1 in 1000 probability of happening, which means they might occur out of the blue.
These side effects include but aren’t limited to the following:
- Severe abdominal pain
- Numbness of the limbs
- Severe skin rash and blisters
- Redness and swelling of the lower jaw
- Visual disturbances and pain in the eyeballs
- Joint swelling
- Severe vomiting
- Pale skin
- Pressure inside the causing dizziness and severe headaches
Should you experience severe side effects, stop the drug and reach out to your doctor immediately.
What Is Sinusitis?
Sinusitis is when the sinuses or ‘air pockets’ inside the head are infected with foreign bodies like bacteria and viruses.
There are four sinuses in the head. They’re the maxillary, frontal, ethmoid, and sphenoid sinuses. These air pockets are lined with specialized respiratory epithelium cells that secrete mucus.
Typically, this mucus drains into the nose. When that draining path is blocked, the mucus will accumulate inside the sinuses, leading to an enabling environment for bacteria and viruses.
Symptoms and Causes of Sinusitis
Several factors can cause sinusitis. Here are some of the typical causes of the infection.
Here are the most common causes of sinusitis:
1. Allergies
Some people are allergic to certain particles in the air. Pollen is usually the culprit for allergy-induced sinusitis.
The body responds to pollen entry by producing an inflammatory reaction in the nasal sinuses. This leads to congestion of the tissues and increased mucus production, eventually leading to blockage and infection.
2. Infection
The common cold is a usual cause of sinusitis. The disease causes inflammation of the nasal tissues, which hinders mucus drainage, ultimately resulting in blocked sinuses.
Sinusitis, in the case of infections, is usually acute and lasts less than 4 weeks.
3. Structural Abnormalities
In some cases, the nasal pathways’ formation could be abnormal. For example, the nasal septum could be slightly deviated, constricting one of the nostrils and hindering mucus drainage.
Nasal polyps can also cause constrictions. These are soft tissue protrusions inside the nose that narrow the nasal pathway.
Sinusitis is often chronic in structural abnormalities since they’re constantly present and causing issues. So, unless these abnormalities are fixed or surgically removed, chronic sinusitis will be present and may last for more than 12 weeks.
Some symptoms indicate sinusitis. Headache is the most common symptom of sinusitis. The air pockets full of mucus produce a consistent, dull-aching pain around the nasal area. That’s usually paired with the nose’s inability to cope with the congestion, which leads to pressure, facial pain, and itchiness.
Some of the symptoms are:
- Blocked nostrils
- Headache or pain around the nose
- Nasal discharge in case of acute sinusitis
- Itchiness
- Strep throat
What Antibiotics Can Treat Sinusitis?
Here are some of the antibiotics used to treat sinusitis if the cause is bacterial:
Penicillin Class Antibiotics:
Penicillin-based antibiotics are the most common drugs to be prescribed for bacterial infections. These broad-spectrum medicines are effective against most bacteria known to man.
Such medications include but aren’t limited to:
- Amoxicillin
- Nafcillin
- Flucloxacillin
- Piperacillin
You can identify penicillin-based medications by looking for the suffix (illin) at the end of the drug’s name.
Non-Penicillin Class Antibiotics:
Penicillin, although quite effective, isn’t prescribed to people allergic to it. Some alternative groups of drugs can still provide a potent bactericidal effect in people allergic to penicillin.
Such groups include but aren’t limited to:
- Tetracyclines (e.g., methacycline and doxycycline)
- Aminoglycosides (e.g., amikacin and neomycin)
- Macrolides (e.g., azithromycin and erythromycin)
- Glycopeptides (e.g., ramoplanin and vancomycin)
Keep in mind that this list doesn’t replace a doctor’s recommendation. In addition, drugs interact with each other, and taking some medications without a prescription could lead to dangerous complications.
Does Nitrofurantoin For Sinus Infections Work?
So far, we’ve established that penicillin and non-penicillin-based antibiotics are broad-spectrum, as they work on most types of bacteria. In addition, nitrofurantoin is also a broad-spectrum drug. However, will it work for sinusitis?
The answer is no. Despite being a broad-spectrum drug, nitrofurantoin won’t work in treating nasal congestion or sinusitis.
The reason is how quickly the drug gets absorbed and secreted in the urine. A drug must stay within a particular environment long enough to achieve its therapeutic effect. So, if a drug is quickly disposed of, it’s unsuitable for blood-borne or head-and-neck infections.
That’s also why nitrofurantoin doesn’t work very well in kidney bacterial infections. But, again, this is because the drug doesn’t stay in the system long enough.
However, once it gets suspended in the urine, it starts affecting the high concentrations of E. coli and other invasive bacteria, permanently damaging their cells from within and lessening the severity of the infection.
When to See a Doctor
Typically, your doctor would prescribe your medication for a certain period and then ask for a follow-up visit. Not skipping that visit is essential even if the signs and symptoms are lessening.
In medicine, the absence of signs and symptoms doesn’t always mean the absence of disease. Your doctor might detect something you may not notice in that follow-up visit.
You should also visit your doctor if any of the severe side effects start to appear. These serious side effects are rare, but something must have gone wrong once they start manifesting. At that point, the intervention of medical personnel might prove to be more fruitful than you think.
Frequently Asked Questions (FAQs)
Nitrofurantoin isn’t effective against sinusitis or blood-borne diseases. The drug may be broad-spectrum, but it doesn’t stay long enough in the bloodstream to treat or prevent sinusitis.
Sinusitis won’t cause any problems to the kidneys of a healthy individual. However, it can cause issues for people with existing kidney conditions.
Some patients with autoimmune disorders can have sinusitis and nasal discharge as manifestations of kidney problems.
Wegener granulomatosis is an example of such an immunity-related disease. Unfortunately, around 90% of patients with this disease will show sinusitis, kidney issues, or even renal failure.
Macrobid or (nitrofurantoin) doesn’t work for sinusitis. This is because the drug gets absorbed, filtered, and secreted quickly by the kidney before it can produce therapeutic effects in the bloodstream.
This is why Macrobid shouldn’t be used against infections of head-and-neck or blood-borne pathogens.
In healthy people, 70% of sinusitis cases will resolve on their own without intervention or usage of medications.
However, the same cannot be said for young infants whose immune system isn’t fully developed yet, seniors who may have underlying conditions, and immunocompromised people.
In other words, if the immune system is either not working efficiently or is busy with an existing condition, you might need antibiotics. It’s best to visit your doctor to know the answer for sure.
Additionally, viral-induced sinusitis won’t be treated with antibiotics, at least during their first stages when the bacteria hasn’t caused a superinfection.
The duration of antibiotics in your system will vary depending on the medication’s half-life. The half-life is the time it takes for your body to absorb, process, and remove half the amount of the drug from your bloodstream.
In simpler words, if a drug has a half-life of 10 hours, it will take 10 hours for your body to eliminate half the drug and 20 hours for complete elimination.
Broad-spectrum penicillin-based antibiotics are the most practical for most common infections, including yeast infections. In addition, they may be replaced by non-penicillin-based antibiotics if there’s a penicillin allergy. However, they’re not OTC (over-the-counter) medications. Antibiotics are also effective against ear infections, and yeast infections caused by antibiotics.
So, even if you accurately understand your condition and its proper antibiotic, a pharmacist will only provide you with the medication if you have a valid written prescription.
