Comparative Pharmacology
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus ZOSYN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus ZOSYN.
NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS) 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 bacterial cell wall synthesis, protein synthesis, and DNA/RNA synthesis. It is bacteriostatic at low concentrations and bactericidal at higher concentrations.
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; for uncomplicated urinary tract infection.
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 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).
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 excretion of unchanged drug accounts for approximately 40% of the dose; tubular reabsorption occurs. Biliary/fecal elimination is minimal (<5%).
Primarily renal; piperacillin 68% unchanged, tazobactam 80% unchanged; biliary/fecal excretion <10%
Category D/X
Category C
Antibiotic
Antibiotic