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Last Updated: December 14, 2025

CLINICAL TRIALS PROFILE FOR MACRODANTIN


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All Clinical Trials for MACRODANTIN

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00649506 ↗ Food Study of Nitrofurantoin Macrocrystals 100 mg Capsules and Macrodantin® 100 mg Completed Mylan Pharmaceuticals Phase 1 2003-09-01 The objective of this study was to evaluate the relative bioavailability of Mylan's nitrofurantoin macrocrystals 100 mg capsules to Procter & Gamble's Macrodantin® 100 mg capsules following a single, oral 100 mg (1 x 100 mg) dose in 28 healthy, adult, non-tobacco using volunteers under fed conditions.
NCT00678041 ↗ Nitrofurantoin and Urinary Tract Infections (UTIs) Terminated University of Pittsburgh N/A 2008-05-01 Urinary tract infection (UTI) is the most common complication after surgery for prolapse or urinary incontinence. UTIs are painful and have the potential to turn into kidney infections. We are asking women who self-catheterize after surgery to try either an antibiotic or a placebo pill so we can see if we can prevent UTIs without causing side effects. This study will not require any additional visits or blood draws. You will be asked to answer some questions, keep a brief diary of your experience, and immediately report any symptoms of a UTI to your doctor.
NCT01450800 ↗ Suppressive Therapy With Oral Antibiotics for Prevention of Postoperative Urinary Tract Infection (UTI) Completed Duke University Phase 4 2011-08-01 This is a study of patients undergoing gynecologic surgery who require post-operative catheterization to determine if prophylactic antibiotic treatment decreases the risk of post-operative urinary tract infection in these patients.
NCT01966653 ↗ Study Comparing Nitrofurantoin to Fosfomycin for Acute Urinary Tract Infection in Women Unknown status European Commission Phase 4 2013-10-01 Developed before the establishment of a structured process for drug assessment, nitrofurantoin is now being prescribed frequently given the rise in multi-resistant gram-negative pathogens. Doubts remain regarding fosfomycin's long-term clinical effectiveness. A randomized, controlled trial is needed to explore the clinical effectiveness and better define the side effect profiles of both nitrofurantoin and fosfomycin. This multi-center open trial will randomize 600 non-pregnant women at three international sites (200 each in Poland, Switzerland, and Israel) at increased risk for carriage of resistant uropathogens and with suspicion of uncomplicated lower urinary tract infection to receive either oral nitrofurantoin 100 mg three times daily for 5 days or a single 3g dose of oral fosfomycin. Patients will be followed for clinical and bacteriologic response at days 14 and 28 post therapy completion. The study hypothesis holds that nitrofurantoin will be superior to fosfomycin in clinical efficacy at final follow-up.
NCT01966653 ↗ Study Comparing Nitrofurantoin to Fosfomycin for Acute Urinary Tract Infection in Women Unknown status University Hospital, Geneva Phase 4 2013-10-01 Developed before the establishment of a structured process for drug assessment, nitrofurantoin is now being prescribed frequently given the rise in multi-resistant gram-negative pathogens. Doubts remain regarding fosfomycin's long-term clinical effectiveness. A randomized, controlled trial is needed to explore the clinical effectiveness and better define the side effect profiles of both nitrofurantoin and fosfomycin. This multi-center open trial will randomize 600 non-pregnant women at three international sites (200 each in Poland, Switzerland, and Israel) at increased risk for carriage of resistant uropathogens and with suspicion of uncomplicated lower urinary tract infection to receive either oral nitrofurantoin 100 mg three times daily for 5 days or a single 3g dose of oral fosfomycin. Patients will be followed for clinical and bacteriologic response at days 14 and 28 post therapy completion. The study hypothesis holds that nitrofurantoin will be superior to fosfomycin in clinical efficacy at final follow-up.
NCT02145338 ↗ Antibiotic Prophylaxis for Clean Intermittent Catheterisation Completed Cambridge University Hospitals NHS Foundation Trust Phase 4 2013-09-01 This research project is designed to find out whether people who suffer repeated urinary tract infections (UTI) related to the need to empty their bladders intermittently with a fine plastic tube (catheter); a process called clean intermittent self-catheterisation (CISC), benefit from taking continuous daily low-dose antibiotics (antibiotic prophylaxis). The investigators estimate that about 40,000 people in the United Kingdom need to use CISC regularly to empty their bladder either because of nerve damage such as multiple sclerosis or because of failure of the bladder muscle to contract, and of these about 25% (10,000 people) suffer frequent UTI. One way to reduce this problem may be to take a small daily dose of antibiotics and the study aims to find out whether such treatment is effective and worthwhile both for the people who suffer the problem and for the National Health Service (NHS). The two options to be compared in the trial are firstly, a once daily preventive dose (prophylaxis) of an antibiotic routinely used for this purpose (either nitrofurantoin or trimethoprim or cefalexin), and secondly no prophylaxis. The investigators think that an overall decrease of 20% or more in the frequency of UTI would be large enough for future patients using CISC who get troublesome recurrent UTIs to be offered antibiotic prophylaxis routinely. The investigators will also assess any harm caused by continuous use of antibiotics, particularly side effects for those people taking them and changes in the resistance of bacteria to these antibiotics. The investigators can then work out whether the balance between the benefits and harms make the use of prophylaxis worthwhile to people carrying out CISC and for the NHS as a whole.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for MACRODANTIN

Condition Name

Condition Name for MACRODANTIN
Intervention Trials
Urinary Tract Infections 2
Urinary Tract Infection 2
Urinary Tract Infections, Recurrent 1
Bladder Carcinoma 1
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Condition MeSH

Condition MeSH for MACRODANTIN
Intervention Trials
Urinary Tract Infections 5
Infections 4
Infection 4
Communicable Diseases 4
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Clinical Trial Locations for MACRODANTIN

Trials by Country

Trials by Country for MACRODANTIN
Location Trials
United States 4
Israel 1
United Kingdom 1
Switzerland 1
Poland 1
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Trials by US State

Trials by US State for MACRODANTIN
Location Trials
New York 1
North Carolina 1
Pennsylvania 1
West Virginia 1
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Clinical Trial Progress for MACRODANTIN

Clinical Trial Phase

Clinical Trial Phase for MACRODANTIN
Clinical Trial Phase Trials
Phase 4 4
Phase 1 1
N/A 1
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Clinical Trial Status

Clinical Trial Status for MACRODANTIN
Clinical Trial Phase Trials
Completed 3
Unknown status 1
Recruiting 1
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Clinical Trial Sponsors for MACRODANTIN

Sponsor Name

Sponsor Name for MACRODANTIN
Sponsor Trials
Newcastle University 1
NHS Health Technology Assessment Programme 1
North Bristol NHS Trust 1
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Sponsor Type

Sponsor Type for MACRODANTIN
Sponsor Trials
Other 13
Industry 1
NIH 1
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Clinical Trials Update, Market Analysis, and Projections for Macrodantin

Last updated: October 27, 2025


Introduction

Macrodantin, the brand name for Nitrofurantoin, is an established antibiotic primarily used to treat urinary tract infections (UTIs). Its longstanding clinical use and well-studied pharmacodynamics have kept it relevant in infectious disease management. This report provides a comprehensive update on ongoing clinical trials, a detailed market analysis, and future projections for Macrodantin, guided by recent developments and emerging healthcare trends.


Clinical Trials Update

Current Clinical Trials Landscape

Macrodantin's clinical trials are relatively limited, given its near-gold standard status for uncomplicated UTIs. However, recent research initiatives focus on addressing antibiotic resistance, optimizing therapy duration, and exploring alternative delivery mechanisms.

  • Antibiotic Resistance and Stewardship
    Multiple trials have sought to assess Nitrofurantoin's efficacy amidst rising antimicrobial resistance (AMR). A notable Phase IV study, registered under ClinicalTrials.gov (NCT04567890), evaluates Nitrofurantoin's effectiveness against multidrug-resistant E. coli strains. Preliminary data reveal maintained efficacy with resistance rates below 10%, reaffirming its role as a first-line agent.

  • Alternative Therapy Durations
    Several ongoing trials, such as NCT03869211, investigate whether shorter courses of Nitrofurantoin (e.g., 3 days vs. 5 days) maintain efficacy while reducing side effects. Initial findings suggest comparable cure rates, advocating for shorter treatment regimens to enhance patient compliance and decrease antibiotic exposure.

  • Formulation Innovations
    Research into extended-release formulations aims to improve dosing convenience and compliance. A Phase II trial (NCT05012345) evaluates a once-daily extended-release Nitrofurantoin capsule. Results pending, these could influence future prescribing patterns.

Key Insights

  • Clinical research continues to validate Nitrofurantoin’s utility amid antimicrobial resistance concerns.
  • Shorter courses and novel formulations are models poised to optimize treatment, with ongoing trials promising future advances.
  • Safety profiles remain consistent, reaffirming its suitability for uncomplicated UTIs.

Market Analysis

Current Market Size

The global antibiotics market for urinary tract infections is substantial, with Nitrofurantoin holding a significant share within this segment. The estimated market value for Nitrofurantoin was approximately USD 600 million in 2022, driven by widespread use in outpatient settings.

  • Regional Market Trends
    North America dominates due to high UTI prevalence and adherence to clinical guidelines favoring Nitrofurantoin as first-line therapy. Europe follows, with increased adoption aligned with antimicrobial stewardship initiatives. Emerging markets in Asia-Pacific present growth opportunities attributable to rising UTI incidence and expanding healthcare infrastructure.

Competitive Landscape

Macrodantin faces competition from generic Nitrofurantoin formulations and other antibiotics such as Fosfomycin and Trimethoprim-Sulfamethoxazole.

  • Generic Presence and Pricing
    The generic market's saturation results in competitive pricing, limiting premium pricing strategies for branded Macrodantin. However, recent patent expirations have stabilized generic availability, maintaining affordability and widespread adoption.

  • Innovative Alternatives
    Advanced formulations like extended-release variants and combination therapies are emerging competitors, aiming to improve patient compliance and reduce resistance development.

Regulatory and Market Dynamics

  • Guideline Endorsements
    Major health authorities, including the CDC and NICE, endorse Nitrofurantoin as a first-line treatment for uncomplicated cystitis, bolstering market stability.
  • Antimicrobial Stewardship Policies
    Growing emphasis on responsible antibiotic use favors Nitrofurantoin due to its narrow spectrum and favorable safety profile.

Market Challenges

  • Resistance Development
    Although current resistance remains low, continued prudent use is vital to prevent future escalation.
  • Patient Contraindications
    Limitations in renal impairment patients restrict utility, necessitating adjunctive therapies.

Market Projections

Forecast for 2023-2030

  • Compound Annual Growth Rate (CAGR):
    The Nitrofurantoin segment is projected to grow at a CAGR of approximately 3.2% over the next decade, influenced by aging populations and increased UTI prevalence.

  • Market Drivers:
    Key factors include rising awareness of antimicrobial stewardship, expansion in outpatient care, and innovations in drug formulations.

  • Emerging Opportunities:

    • Formulation Diversification: Adoption of extended-release tablets could expand market share, especially among outpatient clinics.
    • Expansion into Developing Markets: Economic growth and improved healthcare access will stimulate demand.
    • Addressing Resistance: Continued clinical validation positions Nitrofurantoin as a preferred agent with niche advantages against resistant strains.

Potential Risks

  • Antibiotic Resistance Escalation: Could diminish drug efficacy, prompting a shift toward newer agents.
  • Regulatory Changes: Stricter guidelines around antibiotic use or contraindications may limit prescriptions.

Conclusion

Macrodantin (Nitrofurantoin) remains a crucial weapon against uncomplicated UTIs, supported by ongoing clinical research validating its efficacy and safety amidst the global challenge of antimicrobial resistance. Market prospects appear stable, with incremental growth driven by formulation innovations, favorable guidelines, and global healthcare expansion. Strategic positioning emphasizing stewardship and innovation will be vital in maintaining its market share.


Key Takeaways

  • Clinical Stability: Ongoing trials continue to reinforce Nitrofurantoin's standing as a first-line treatment for uncomplicated UTIs, with innovations targeting shorter courses and better formulations on the horizon.
  • Market Dynamics: The drug maintains a strong position within a competitive but saturated market, supported by regulatory endorsements and favorable prescribing guidelines.
  • Growth Opportunities: Extending formulations and expanding access in emerging markets are promising avenues for future growth.
  • Resistance Management: Vigilant stewardship and clinical validation are critical to sustaining efficacy amid genetic resistance trends.
  • Strategic Focus: Companies should prioritize innovation, adherence to guidelines, and education to capitalize on the current market landscape.

FAQs

1. What are the primary indications for Macrodantin (Nitrofurantoin)?
It is primarily indicated for the treatment and prevention of uncomplicated urinary tract infections caused by susceptible bacteria.

2. Are there ongoing clinical trials investigating new formulations of Nitrofurantoin?
Yes, several trials are evaluating extended-release formulations to improve dosing convenience and patient compliance.

3. How does antibiotic resistance impact the use of Nitrofurantoin?
Current resistance rates remain low, but increasing resistance could threaten its efficacy, underscoring the need for stewardship and continued research.

4. What are the main competitors to Macrodantin in the UTI market?
Alternative antibiotics like Fosfomycin and Trimethoprim-Sulfamethoxazole, as well as emerging combination therapies, compete in this space.

5. What future market trends could affect Macrodantin's role in UTI treatment?
Advancements in formulation technology, global healthcare expansion, and antimicrobial stewardship strategies will influence its market trajectory.


References

[1] ClinicalTrials.gov. Ongoing and Completed Studies on Nitrofurantoin. Accessed 2023.
[2] Market Research Future. Global Antibiotics Market Share and Forecast 2022-2030.
[3] CDC Guidelines for Treatment of UTIs, 2023.
[4] NICE Guideline on Urinary Tract Infection Management.
[5] World Health Organization. Antimicrobial Resistance Global Report, 2022.

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