Furan (C4H4O) – is an organic compound which can be formed during food thermal processing. By the way, it is an undesirable compound because it’s classified by science as “possible human carcinogen”. But before our daily cup of coffee will kill us (large quantities of furan are formed during roasting of coffee beans) let’s look at the brighter side of furan. Scientists were able to synthesize a lot of furan related structures called nitrofurans and some of them were employed for treatment of bacteria-induced diseases (diarrhea included) of people and animals. Although the metabolism of nitrofurans is not well documented, they work somehow.
Unfortunately people started very fast to overuse nitrofurans in animals – especially in liverstock, poultry, swine etc – treating it as a prophylactic feed additive to promote growth by inhibiting potential protozoan or bacterial infections. Suddenly someone woke up and discovered that nitrofurans residues in animals tissue (it means it’s in the meat you consume) are harmful to human health. Surprise surprise! 🙂 So some time ago, use of nitrofurans antibiotics in animal husbandry was banned in UE and then in U.S, Australia, and some other countries as well.
Some of these drugs are still available for human and veterinary medicine although they are not the first choice medicines to use. Examples of nitrofurans: nitrofurazone (mostly topical application), furalozlidone ( sometimes used in Giardia treatment in dogs – prolonged use has some serious side effects.), nitrofurantoin for urinary tract infection (a dog can vomit taking it) and nifuroxazide. The latter patented in 1966 is sold under different brand names and used to treat diarrhea and colitis mainly in people, sometimes it can be given to dogs based on the dosage for people.
Nifuroxazide is not absorbed from the gastrointestinal tract, doesn’t change intestinal bacterial flora drastically and have one big advantage, somehow the bacteria still develops poor resistance against it. (at least appropriate data has not yet been estimated). The lack of bacterial resistance encourages scientists search for a Nifuroxazide analogue which could prove useful in the fight against MRSA –hospital “nightmare” bacteria, Staphylococcus aureus.
As for people treatment, some studies were carried to check Nifuroxazide effectiveness for example in so-called traveler’s diarrhea. It even showed some prophylactic effect in such cases: 77% of people taking the medicine (healthy participants of a car rally in Morocco, year 1986 ) did not experience diarrhea or its time was reduced to a maximum of 72 hours with significantly ameliorated symptoms of the disease.
Nonetheless, over the years, Nifuroxazide slowly fell into oblivion. It was sometimes mentioned in the scientific press, for example in 2007 it was even accused of causing autoimmune pancreatitis – but that seemed to be a single case.
In a year 2016, an interesting report appeared. In Sarajevo (Bosnia and Herzegovina) an open clinical trial of Nifuroxazide versus probiotics was performed on a group of 169 adult patients suffering from acute diarrhea. Nifuroxazide was an unquestionable winner. Most importantly, no side effects were observed during the trial.
It should be remembered though, that Nifuroxazide should not be administered simultaneously with metronidazole, sulfonamides (eg.popular Bactrim) other nitrofurans used, and with antifungal agents. Under no circumstances should you (nor your dog ;)) drink alcohol while on Nurofoxazide because this leads to serious adverse reactions. It is also better to avoid using benzodiazepines and other sedative drugs at the same time.
Nifuroxazide can be ineffective for some bacteria especially Shigella, or Salmonella. It is supposed that when bacteria penetrate deeper into epithelial cells they are hidden from the medicine.
Always better consult your vet before giving Nifuroxazide to your dog. If there is no such possibility the medicine can be applied twice daily in a dose from 1 to 2,5mg/kg/bw ( 1 to 2,5 milligrams for one kilogram of body weight). Treatment should not last longer than a few days (for people max. 7 days is recommended).
1 Effects of nifuroxazide on fecal flora in healthy subjects. Buisson Y, Larribaud J. Therapy. 1989 Mar-Apr;44(2):123-6
2 Leoberto Costa Tavares. A new class of nifuroxazide analogues: synthesis of 5-nitrothiophene derivatives with antimicrobial activity against multidrug-resistant Staphylococcus aureus. Andrea Masunari;.Bioorganic & Medicinal Chemistry [25 Mar 2007, 15(12):4229-4236]
3 Patrice Bourée ,Gerard Kouchne ,Michel Ponti .Double-blind study of traveller’s diarrhoea using Nifuroxazide. Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 81, Issue 5, 1
Accessed 11.04.2018: https://academic.oup.com/trstmh/article-abstract/81/5/859/1885636
.4 Shindano A, Marot L, Geubel AP. Nifuroxazide-induced acute pancreatitis: a new side-effect for an old drug? Acta Gastroenterol Belg. 2007 Jan-Mar;70(1):32-3.
Accessed 11.04.2018 :https://www.ncbi.nlm.nih.gov/pubmed/17619536
5Begler Begovic, Sead Ahmedtagic, Lejla Calkic, Midhat Vehabović, Sanela Bakić Kovacevic, Tarik Catic, and Meliha Mehic. Open Clinical Trial on Using Nifuroxazide Compared to Probiotics in Treating Acute Diarrhoeas in Adults. Mater Sociomed. 2016 Dec; 28(6): 454–458
Accessed 11.04.2018 pod adresem : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5239654/
6 https://pharmacybook.net/nifuroxazide/ Accessed 11.04.2018
Accessed 11.04.2018 : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385941/
7David N. Taylor Poorly Absorbed Antibiotics for the Treatment of Traveler’ Diarrhea .Clinical Infectious Diseases, Volume 41, Issue Supplement_8, 1 December 2005, Pages S564–S570,
Accessed 11.04.2018: https://academic.oup.com/cid/article/41/Supplement_8/S564/570241
8 Bismuth C, Fréjaville JP, Pebay-Peyroula F, Leclerc JP. Nifuroxazide in Diarrhea
Accessed 11.04.2018 : http://www.idthai.org/Publication/pdf/Vol8%20-%202/p.87-89.pdf
9https://www.vri.cz/docs/vetmed/53-9-469.pdf Accessed 11.04.2018