Comparative Pharmacology
Head-to-head clinical analysis: NITROFURANTOIN MACROCRYSTALLINE versus ZOSYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROFURANTOIN MACROCRYSTALLINE versus ZOSYN.
NITROFURANTOIN MACROCRYSTALLINE vs ZOSYN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nitrofurantoin is reduced by bacterial flavoproteins to reactive intermediates that inhibit multiple bacterial enzymes involved in carbohydrate metabolism, including acetyl-CoA synthetase, and disrupt cell wall synthesis.
Piperacillin, a semisynthetic penicillin, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs). Tazobactam, a beta-lactamase inhibitor, inactivates beta-lactamases, preventing piperacillin degradation.
100 mg orally twice daily for 5-7 days (uncomplicated UTI); 100 mg orally every 12 hours for 10-14 days (pyelonephritis: not first-line).
3.375 g (piperacillin 3 g / tazobactam 0.375 g) intravenously every 6 hours over 30 minutes; for nosocomial pneumonia, 4.5 g intravenously every 6 hours.
None Documented
None Documented
Terminal half-life: 20-60 minutes (short, requires q6h dosing for therapeutic efficacy).
Piperacillin ~0.7-1.2 h; tazobactam ~0.7-1.0 h; extended in renal impairment (piperacillin up to 3.3 h, tazobactam up to 4.7 h in CrCl <20 mL/min)
Renal: 30-40% excreted unchanged in urine. Biliary/fecal: minimal; remainder metabolized or eliminated via other routes.
Primarily renal; piperacillin 68% unchanged, tazobactam 80% unchanged; biliary/fecal excretion <10%
Category D/X
Category C
Antibiotic
Antibiotic