Comparative Pharmacology
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus SYNERCID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus SYNERCID.
NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS) vs SYNERCID
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 bacterial cell wall synthesis, protein synthesis, and DNA/RNA synthesis. It is bacteriostatic at low concentrations and bactericidal at higher concentrations.
Synercid is a combination of two streptogramin antibiotics, quinupristin and dalfopristin, which bind to the 50S bacterial ribosome and inhibit protein synthesis. Quinupristin binds to the 23S rRNA near the peptidyl transferase center, while dalfopristin binds to a nearby site and enhances quinupristin's binding. The synergistic effect results in irreversible inhibition of bacterial protein synthesis.
100 mg orally twice daily for 5-7 days; for uncomplicated urinary tract infection.
7.5 mg/kg IV every 8 hours, administered as a 60-minute infusion.
None Documented
None Documented
Terminal elimination half-life: 20-60 minutes (average ~30 min) in patients with normal renal function; prolonged in renal impairment (e.g., CrCl <60 mL/min).
The terminal elimination half-life is approximately 0.85 hours for dalfopristin and 1.3 hours for quinupristin; however, the active metabolite of quinupristin has a half-life of about 3.5 hours, supporting twice-daily dosing.
Renal excretion of unchanged drug accounts for approximately 40% of the dose; tubular reabsorption occurs. Biliary/fecal elimination is minimal (<5%).
Primarily hepatic metabolism with biliary excretion; approximately 15% of the dalfopristin dose and 32% of the quinupristin dose are excreted unchanged in feces; renal excretion is minor (<5% for both components).
Category D/X
Category C
Antibiotic
Antibiotic