Revolutionizing Nitrofurantoin Delivery: Unraveling Challenges and Pioneering Solutions for Enhanced Efficacy in UTI Treatment

Nitrofurantoin is an antimicrobial drug, highly effective in the treatment of critical or chronic bacterial infections of the urinary tract, and hence, it is the first line choice of drug for the treatment of urinary tract infections (UTI). Although the molecule is legacy in nature, there are many challenges in terms of drug product formulation and efficacy thereof. The authors are mainly focused in this literature review on, but not limited to, understanding the molecule in terms of physico-chemical properties of the drug, pharmacokinetics and pharmacodynamics, approved and withdrawn formulations, challenges concerning drug formulation, the cause of drug shortage in the market, improvement areas in terms of formulation and its therapeutic effectiveness. The authors found during their widespread review that the major challenge in the existing conventional drug delivery system of nitrofurantoin is the fluctuation of plasma concentration owing to its variability in drug absorption. Further, they understood that the variability in absorption is due to inherent variability in particle size distribution. Based on the findings, authors also explored the possibilities to deliver the drug in novel drug delivery systems such as nano self-emulsifying emulsions, nanoemulsions and multiple emulsions where the drug can be presented in soluble form and hence the variability in absorption and fluctuation in plasma concentration of drug can be avoided and described briefly the salient features of each drug delivery in this review.