Macrobid / Nitrofurantoin - Mothering Forums

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Old 04-18-2009, 12:44 AM - Thread Starter
 
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Okay... I'm 36 weeks pregnant with my first, seeing an OB in a group practice. I went in to the doctor yesterday over a scare about decreased fetal movement (which isn't a problem, did a NST that was completely reassuring and everything's fine). But since my OB wasn't there, I saw a different doctor (first time I have seen anyone there other than my specific OB). I've had a few other concerns in the past few weeks, some blood pressure / protein in urine concerns that have fallen short of being outright pre-eclampsia. So after checking my urine while I'm there, the doctor says that there are trace amounts of blood and some bacteria in my urine, that she thinks it may be a bladder infection, but she isn't sure, but it seems that something is going on ( I think the words she used is "there is a mix of bacteria" ) and wants me to go ahead and take an antibiotic. She writes me a prescription for Macrobid.

So I get it filled (the generic was given to me, Nitrofurantoin Mono / Mac 100 MG Caps), and I'm reading the prescription information. It says "THIS MEDICINE SHOULD ONLY BE USED WHEN CLEARLY NEEDED DURING PREGNANCY [it is in all caps on the paper]. Discuss the risks and benefits with your doctor. Avoid use at or past term (38 to 42 weeks of pregnancy) and during labor and delivery."

So... hmm. I'm not exactly at term, but I'm past 36 weeks, which is close enough for this to worry me. And, she did NOT discuss any risks or benefits with me. And wasn't even sure that it was a bladder infection or what it was (I've felt no symptoms of anything being wrong, although of course I realize that I could have an infection without being aware-- just saying, I'm not feeling ill or anything). So I'm really hesitant to take this. I was going to start it tonight, but now I don't want to. [It doesn't help that this doctor seemed a bit clueless, made a few comments that made it obvious that she hadn't really looked at my records, and seemed pretty inexperienced.]

I could call my doctor, but of course I don't realize this until a Friday evening and now it's the weekend. I already have an appointment for first thing Monday morning, so I'm considering just holding off on taking this stuff until then, when I can talk to him about it in person.

Do any of you have any particular experience with this antibiotic? Would it be contraindicated for someone at my stage of pregnancy? Is there any specific reason to use this antibiotic over any other (I've never had or heard of this one before, and I have absolutely no drug allergies that would make any other drug inappropriate for me personally)?

Kelly (28), in love with husband Jason (38) and our awesome babies:  Emma 4/09, and Ozzy 8/10

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Old 04-18-2009, 12:54 AM
 
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here is why it is counterindicated at term---

"Because of the possibility of hemolytic anemia due to immature erythrocyte enzyme systems (glutathione instability), the drug is contraindicated in pregnant patients at term (38-42 weeks gestation), during labor and delivery, or when the onset of labor is imminent. For the same reason, the drug is contraindicated in neonates under one month of age.

Macrobid is contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin.

Macrobid is also contraindicated in those patients with known hypersensitivity to nitrofurantoin."

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Old 04-18-2009, 01:42 AM
 
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Not a birth professional, but BTDT:

Last weekend I was given a prescription for Macrobid for a bladder infection - same scenario. I'm at 37 weeks. Got the script filled, the pharmacist read me the warning that mwherbs posted. It also has the warning "not for breastfeeding mothers" and I'm still nursing DS.

I waited to take the medicine and called my midwife in the morning. I got a different midwife who was on call. She didn't comment on the appropriateness or lack thereof, but quickly offered to switch the prescription to Keflex. Keflex doesn't have any warning like this. I'm now on Keflex and feel so much better in case I do go into labor soon.

Did you do a urine culture and sensitivity? We checked to make sure whatever germs were growing were sensitive to the specific antibiotic. This works well unless you are acutely ill and can't wait 48 hours for the results.

Good luck!

: DS - June '07 : DS2 - May '09 : (may be delayed a really long time!)
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