Key takeaways
Fosfomycin (Monurol) and nitrofurantoin (Macrobid) are both antibiotics used to treat urinary tract infections (UTIs). However, they belong to different medication classes and have distinct characteristics. Fosfomycin is an antibacterial that is typically taken as a single oral dose, making it convenient for treating uncomplicated UTIs in women. It is also used off-label for UTIs in men and prostate infections. Nitrofurantoin, a nitrofuran antibiotic, is used for both treating and preventing UTIs and is taken more frequently, usually twice a day for 7 days. Fosfomycin is available only as a powder mixed with water, while nitrofurantoin comes in capsules and oral suspension forms. Common side effects of fosfomycin include diarrhea, nausea, and headache, whereas nitrofurantoin may cause nausea, headache, and gas. Fosfomycin has fewer drug interactions, while nitrofurantoin can interact with antacids and certain supplements. Additionally, nitrofurantoin is not recommended for use in the last weeks of pregnancy due to potential risks to the unborn baby, whereas fosfomycin is considered safe during pregnancy.
