Paediatric dose of nitrofurantoin,6 years
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Nitrofurantoin - Paediatric Dose (6-year-old)
Treatment Dose (Cystitis / Lower UTI)
| Parameter | Details |
|---|---|
| Dose | 5 mg/kg/day divided into 2 doses |
| Route | Oral |
| Duration | 7 days |
| Indication | Uncomplicated cystitis (2nd-line after cephalexin) |
Practical example for a 6-year-old (average weight ~20 kg):
- Total daily dose: 5 mg/kg × 20 kg = 100 mg/day
- Per dose: 50 mg twice daily
Goodman & Gilman gives the range as 5-7 mg/kg/day for treatment, so doses up to 140 mg/day (for a 20 kg child) are within the therapeutic range.
Prophylaxis Dose (long-term suppression / recurrent UTI)
| Parameter | Details |
|---|---|
| Dose | 1-2 mg/kg once daily at bedtime |
| Duration | Long-term as clinically indicated |
Important Notes
- Not recommended under 1 month of age (risk of haemolytic anaemia due to immature erythrocyte glutathione instability)
- Avoid in renal impairment - drug concentrates inadequately in urine and systemic toxicity increases
- Not for pyelonephritis - does not achieve adequate tissue/plasma levels; use only for lower UTI
- Urine acidity - activity is higher in acidic urine; avoid alkalinising agents
- Give with food to reduce GI side effects (nausea, vomiting)
- Urine may turn brown - warn parents
Sources:
- Goodman & Gilman's Pharmacological Basis of Therapeutics, Chapter on Nitrofurantoin (p. 1193)
- Smith and Tanagho's General Urology, 19th Ed., Table 14-7 (Paediatric UTI antimicrobials)
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