Antibiotics Study

There are 3 antibioctics that im interested.
1. Cephalexin
2. Nitrofurantoin
3. cotrimoxazole

All the above are antobiotics to treat UTI, especially E.coli bacteria.

Bb's been taking Cephalexin since she was discharged in April. 3 doses per day for 2 weeks. then once a day for 7 weeks.

In between, we switched to Nitrofurantoin as advised by Dr Chao Xin ming ( the nephrology specialist we are seeing now in KKH private children clinic )

So, this antibiotics is a mild antibioctics which is oral administered that does not achieve significant blood and tissue levels but is excreted in the actuve form in the urine. It is therefore only used for the treatment of uncomplicated lower urinary tract infection due to mosy gram positive or gram-negative bactiria.


extracted from website
Nitrofurantoin.
Nitrofurantoin is an anti-bacterial drug that is used to treat urinary tract infections caused by many gram-negative and some gram-positive bacteria. (Nitrofurantoin was approved by the FDA in 1953.) There are three forms of nitrofurantoin available: a microcrystalline form (Furadantin), a macrocrystalline form (Macrodantin), and a sustained release, macrocrystalline form used twice daily (Macrobid).
Nitrofurantoin can cause acute and chronic liver disease. Most commonly, nitrofurantoin causes mild and reversible elevations in blood levels of liver enzymes without symptoms. In rare instances, nitrofurantoin can cause hepatitis.
Symptoms of nitrofurantoin hepatitis include:
• fatigue,
• fever,
• muscle and joint aches,
• poor appetite,
• nausea,
• weight loss,
• vomiting,
• jaundice, and
• sometimes itching.
Some patients with hepatitis also have a rash, enlarged lymph glands, and nitrofurantoin-induced pneumonia (with symptoms of cough and shortness of breath). Blood tests usually show elevated liver enzymes and bilirubin. Recovery from hepatitis and other skin, joint, and lung symptoms is usually rapid once the drug is stopped. Serious liver disease such as acute liver failure and chronic hepatitis with cirrhosis mostly occur in patients who continue the drug despite developing hepatitis.

so far bb does not exhibit any side effect from the once daily antibiotics. it is rather worrying with the long term side effect to the liver. But i guess doctor must have reason for the continuing oral antibioctics. she said to prevent UTI till she is 1 year old.

The alternative antibiotics that bb can take is cotrimoxazole ( trimethoprim + Sulhamethoxazole), this is also to treat UTI. it active against a broad spectrum of gram-negative and gram-positive bacteria. This combination is used to treat gram-negative UTI Side effect is skin rashes inclusing Stevens-Johnson Syndrome.

bb does not like the taste of Nitrofurantoin, but due to the stronger side effect from cotrimoxazole, i rather continue with nitrofurantoine than switching over to cotrix.

So, shall seek doc advise when see her again in July.