Nitrofurantoin: friend or foe?

Kapral, Nicole; Saxena, Rovin; Sule, Anupam A; Markle, Brian

doi:10.1136/dtb.2018.225629rep

Cited by 3 publications

(2 citation statements)

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“…The first published report of nitrofurantoin-induced liver injury was in 1961, 6 with an appreciable number of reports since then. [7][8][9][10][11][12][13][14][15] Nitrofurantoin has been shown to cause a spectrum of hepatic injury ranging from mild hepatitis to fulminant liver failure and death. 9,10 Despite this, the overall incidence of liver injury is very rare, reported at 0.0003%.…”

Section: Discussionmentioning

confidence: 99%

Nitrofurantoin-induced liver failure

Luk¹,

Edwards

Bates

et al. 2021

Can Fam Physician

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Section: Discussionmentioning

confidence: 99%

Nitrofurantoin-induced liver failure

Luk¹,

Edwards

Bates

et al. 2021

Can Fam Physician

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“…[5] The precise mechanisms of adverse effects are not fully understood. [7][8][9] Current adult British National Formulary (BNF) guidelines state: "On long-term therapy, monitor liver function and monitor for pulmonary symptoms, especially in the elderly (discontinue if deterioration in lung function)". However, neither a method nor frequency of hepatic/pulmonary monitoring, nor a definition for "long-term" is suggested.…”

Section: Introductionmentioning

confidence: 99%

Long-term nitrofurantoin: an analysis of complication awareness, monitoring, and pulmonary injury cases

et al. 2021

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BackgroundLong-term nitrofurantoin (NF) treatment can result in pulmonary and hepatic injury. Current guidelines do not outline the type or frequency of monitoring required for detection of these injuries.AimsTo assess (1) awareness of NF complications among prescribers, (2) monitoring practice and (3) to describe the pulmonary sequelae of NF-related complications.Methods(1) Electronic questionnaire to prescribers, interrogating prescribing/monitoring practices and awareness of complications; (2) Case-note review (June-July 2020) of NF monitoring among general practitioners (GPs) in our local clinical commissioning group; (3) Case review of patients diagnosed with nitrofurantoin-induced interstitial lung disease (NFILD) at our interstitial lung disease (ILD) centre (2014-2020).Results125 prescribers of long-term NF responded to the questionnaire (82% GPs; 12% urologists). Many were unaware of the potential for liver (42%) and lung (28%) complications. 41% and 53% never monitored for these, respectively. Only 53% of urologists believed themselves responsible for arranging monitoring, whilst nearly all GPs believed this to be the prescriber’s responsibility (94%). One third of all respondents considered current British National Formulary (BNF) guidelines “not at all sufficient/clear”, with mean clarity scoring of 2.2/5. Amongst NFILD patients (n=46), NF had been prescribed most often (70%) for treatment of recurrent UTI and 59% (n=27) were prescribed for >6 months. Upon withdrawal of the medication 61% displayed resolution (completely/minimal fibrosis), whilst 16% of patients had progressive lung fibrosis.ConclusionNF can cause marked or irreversible lung complications and there is currently a shortfall in awareness and monitoring. Existing monitoring guidelines should be augmented.

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Nitrofurantoin

2019

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Nitrofurantoin: friend or foe?

Cited by 3 publications

References 5 publications

Nitrofurantoin-induced liver failure

Nitrofurantoin-induced liver failure

Long-term nitrofurantoin: an analysis of complication awareness, monitoring, and pulmonary injury cases

Nitrofurantoin

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