• Type: Antibiotic
  • Dosage Forms: oral
  • Common Trade Names: Monurol

Adult Dosing

  • Uncomplicated UTI: 3g PO x 1

Pediatric Dosing

  • >12 y/o: 3 g PO x 1

Special Populations

  • Pregnancy Rating: B
  • Lactation Risk: Infant risk cannot be ruled out
  • Renal Dosing: Half life increased in renal impairment, no specific adjustment
  • Hepatic dosing: no adjustment


  • Allergy to class/drug
  • Caution if hepatic impairment
  • Caution if recent antibiotic-associated colitis

Adverse Reactions


  • Angioedema
  • Aplastic Anemia
  • Asthma Exacerbation
  • Hepatic Necrosis
  • Toxic Megacolon
  • C. difficile diarrhea


  • Diarrhea
  • Vaginitis
  • Rhinitis
  • nausea
  • headache
  • dizziness
  • back pain
  • abdominal pain
  • dysmenorrhea


  • Half-life: 5.7 hours
  • Metabolism:
  • Excretion: Urine 38%, Feces 18%
  • Mechanism of Action: Bactericidal, inhibits cell wall synthesis

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram PositiveStrep. Group A, B, C, GX1
Strep. PneumoniaeS
Viridans strepX1
Strep. anginosus gpX1
Enterococcus faecalisS
Enterococcus faeciumI
Staph. EpidermidisX1
C. jeikeiumX1
L. monocytogenesR
Gram NegativesN. gonorrhoeaeX1
N. meningitidisX1
Moraxella catarrhalisX1
H. influenzaeX1
E. coliS
Klebsiella spS
E. coli/Klebsiella ESBL+S
E coli/Klebsiella KPC+S
Enterobacter sp, AmpC negS
Enterobacter sp, AmpC posS
Serratia spX1
Serratia marcescensS
Salmonella spS
Shigella spX1
Proteus mirabilisX1
Proteus vulgarisS
Providencia sp.X1
Morganella sp.X1
Citrobacter freundiiX1
Citrobacter diversusX1
Citrobacter sp.X1
Aeromonas spX1
Acinetobacter sp.R
Pseudomonas aeruginosaR
Burkholderia cepaciaX1
Stenotrophomonas maltophiliaX1
Yersinia enterocoliticaX1
Francisella tularensisX1
Brucella sp.X1
Legionella sp.X1
Pasteurella multocidaX1
Haemophilus ducreyiX1
Vibrio vulnificusX1
MiscChlamydophila spX1
Mycoplasm pneumoniaeX1
Rickettsia spX1
Mycobacterium aviumX1
Bacteroides fragilisX1
Prevotella melaninogenicaX1
Clostridium difficileX1
Clostridium (not difficile)X1
Fusobacterium necrophorumX1
Peptostreptococcus sp.X1


  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia


  1. Sanford Guide to Antimicrobial Therapy 2014
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