Evaluation of the Risk of Nitrofurantoin Lung Injury and Its Efficacy in Diminished Kidney Function in Older Adults in a Large Integrated Healthcare System: A Matched Cohort Study

Santos, Jody M.; Batech, Michael; Pelter, Mitchell A.; Deamer, Robert L.

doi:10.1111/jgs.14072

Cited by 20 publications

(17 citation statements)

References 28 publications

(66 reference statements)

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“…A retrospective study of male veterans with UTI treated with nitrofurantoin showed a clinical cure rate of 77% rate, which is comparable to other agents [71]. Decreased creatinine clearance predicted clinical failure in this study; however, two additional studies in older adults, one limited to women, refuted the concern that nitrofurantoin is less effective in treating UTI in patients with reduced creatinine clearance [72–73]. Particularly in older adults, for whom adverse event profile and collateral damage to the microbiome are important considerations, nitrofurantoin is a good choice for uncomplicated UTIs, including in men with preserved renal function.…”

Section: Treatment Of Utismentioning

confidence: 69%

Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

Cortés-Penfield

Trautner

Jump

2017

Infectious Disease Clinics of North America

146

105

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Synopsis Urinary tract infections (UTIs) are a significant cause of morbidity among older adults; however, antibiotic prescriptions for clinically suspected UTIs are often inappropriate. Healthcare providers frequently struggle to differentiate UTI from asymptomatic bacteriuria, particularly in patients presenting with nonspecific symptoms. Patients with baseline cognitive impairments that limit history-taking can be particularly challenging. Here, we review the epidemiology and pathogenesis of UTI in older adults. We also discuss an approach to the diagnosis and treatment of UTIs, focusing on recognizing patients who would likely benefit from antibiotic treatment and on identifying patients for whom empiric antibiotic therapy should not be given.

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Section: Treatment Of Utismentioning

confidence: 69%

Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

Cortés-Penfield

Trautner

Jump

2017

Infectious Disease Clinics of North America

146

105

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“…Chronic interstitial pneumonia is a rarer presentation mimicking pulmonary fibrosis [ 75 , 76 , 77 ], and is more common in patients on long-term prophylaxis [ 76 ]. Santos et al performed a case-control study comparing DIILD with nitrofurantoin use compared to other antibiotics [ 78 ]. Overall, the relative risk (RR) of DIILD was not increased for nitrofurantoin.…”

Section: Resultsmentioning

confidence: 99%

Drug-Induced Interstitial Lung Disease: A Systematic Review

Skeoch

Weatherley

Swift

et al. 2018

JCM

235

241

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Background: Drug-induced interstitial lung disease (DIILD) occurs as a result of numerous agents, but the risk often only becomes apparent after the marketing authorisation of such agents. Methods: In this PRISMA-compliant systematic review, we aimed to evaluate and synthesise the current literature on DIILD. Results: Following a quality assessment, 156 full-text papers describing more than 6000 DIILD cases were included in the review. However, the majority of the papers were of low or very low quality in relation to the review question (78%). Thus, it was not possible to perform a meta-analysis, and descriptive review was undertaken instead. DIILD incidence rates varied between 4.1 and 12.4 cases/million/year. DIILD accounted for 3–5% of prevalent ILD cases. Cancer drugs, followed by rheumatology drugs, amiodarone and antibiotics, were the most common causes of DIILD. The radiopathological phenotype of DIILD varied between and within agents, and no typical radiological pattern specific to DIILD was identified. Mortality rates of over 50% were reported in some studies. Severity at presentation was the most reliable predictor of mortality. Glucocorticoids (GCs) were commonly used to treat DIILD, but no prospective studies examined their effect on outcome. Conclusions: Overall high-quality evidence in DIILD is lacking, and the current review will inform larger prospective studies to investigate the diagnosis and management of DIILD.

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“…Although the Food and Drug Administration recommended against using nitrofurantoin in patients with a creatinine clearance (CrCl) 60 milliliters/minute (mL/min), recent data suggest that nitrofurantoin can be used effectively for cystitis regardless of renal function. 48,49 The risk of pulmonary toxicity is greater in adults with a CrCl 30 mL/min and the Beers criteria recommend against use of nitrofurantoin in older adults !65 years with a CrCl 30 mL/min. 50 More recently an AHRQ funded project used Delphi procedure to reach a consensus on a set of recommendations for the empirical treatment of cystitis in nursing home residents.…”

Section: Choosing Empiric Antibioticsmentioning

confidence: 99%