Nitrofurantoin-induced lung disease and prophylaxis of urinary tract infections

Abstract

SummaryNitrofurantoin is commonly used for the treatment and prophylaxis of recurrent urinary tract infections (UTIs). Although relatively rare, nitrofurantoin is one of the commonest causes of drug-induced pulmonary disease, which can be potentially serious and even fatal. Knowledge of such potential adverse effects is essential to enable early recognition and withdrawal of the drug. Patients on long-term nitrofurantoin should be reviewed and monitored regularly. Management involves early consideration of the condition, and prompt withdrawal of the drug. We report three cases of nitrofurantoin-induced lung disease in patients who were on long-term nitrofurantoin for UTI prophylaxis and present a brief review of the literature on this subject.

Diagnosis and management of recurrent urinary tract infections in non-pregnant women

“…Fortunately, reports suggest that pulmonary toxicity reverses on discontinuation of nitrofurantoin. 31 32 …”

The challenges of treating women with recurrent urinary tract infections in primary care: a qualitative study of GPs’ experiences of conventional management and their attitudes towards possible herbal options

“…Long-term prophylaxis has been shown to reduce the risk of recurrence of UTIs in comparison to placebo (Albert et al , 2004) but when treatment is discontinued, risk of infection returns to that of a placebo controlled group. Antibiotic prophylaxis is associated with unpleasant, and occasionally serious adverse effects (Madani and Mann, 2012). Furthermore, there are increasing concerns about microbial resistance (Kumarasamy et al , 2010).…”

Recurrent nitrofurantoin-induced giant cell interstitial pneumonia: Case report and literature review

“…Both acute and chronic manifestations have been reported [4,5] . Acute pulmonary reactions, which occur hours to days into a course of nitrofurantoin, are more common and typically manifest as an eosinophilic pneumonia or hypersensitivity reaction [6,7] . Chronic pulmonary reactions to nitrofurantoin, which occur months to years after daily nitrofurantoin use, present as interstitial pneumonitis and fibrosis.…”