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Macrodantina is an oral small molecule antibiotic containing nitrofurantoin in a macrocrystalline formulation, developed and marketed by Mantecorp. It is specifically indicated for the treatment of acute and chronic urinary tract infections (UTIs), including cystitis, pyelitis, pyelocystitis, and pyelonephritis. The macrocrystalline form is designed to provide delayed solubility in the gastrointestinal tract, which helps reduce common side effects such as nausea and vomiting without compromising urinary excretion levels. Nitrofurantoin acts as a prodrug that is activated by bacterial nitroreductases into highly reactive electrophilic intermediates. These intermediates non-specifically attack bacterial macromolecules, including ribosomal proteins, DNA, and RNA, thereby inhibiting protein synthesis and metabolic processes, leading to bacterial cell death. It is particularly effective against common urinary pathogens such as Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus.
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