Nitrofurantoin-induced lung- and hepatotoxicity

Acute Respiratory Distress Syndrome and Hepatotoxicity Associated with Single Dose Nitrofurantoin Use

“…NF is absorbed from the gastrointestinal tract, metabolized by glutathione S-reductase enzyme system in liver, and is mainly excreted by urinary system [1, 2]. …”

“…Koulaouzidis et al reported a case of pulmonary and hepatotoxicity with the use of low dose (100 mg daily) NF for 16 months [2]. Similarly, isolated acute respiratory failure developed in a pregnant patient after 48 hours with the use of NF (200 mg daily) [7].…”

“…It is known that NF may cause pulmonary reactions and hepatotoxicity [1–4]. Nevertheless, simultaneous development of pathological changes in the lung and liver is a very rare occasion [2]. On the other hand, the literature search did not reveal any articles reporting cases of concurrent development of acute respiratory distress syndrome (ARDS) and hepatotoxicity with administration of a single dose of this agent.…”

Nitrofurantoin-induced immune-mediated lung and liver disease

“…Adverse drug reactions to nitrofurantoin include pulmonary reactions, hepatic toxicity, blood dyscrasias, peripheral neuropathy, etc 9 . Concomitant pulmonary and hepatic toxicity secondary to nitrofurantoin is rare with few reported cases [4][5][6][7][8] . The vast majority of pulmonary reactions to nitrofurantoin (90%) are acute and characterised by fever, cough, dyspnoea, and peripheral eosinophilia [9][10] .…”

Antimicrobials in urogenital infections

“…Nitrofurantoin is mainly used in preventing recurrent UTI in children and women [18]. Potential severe side effects with nitrofurantoin were reported, such as lungand hepatotoxicity, especially in long-term usage [19]. Due to the effective gastro-intestinal absorption of nitrofurantoin the effect on the intestinal flora is minimal [20].…”