Why nitrofurantoin renal failure

Several recent publications questioning the evidence for this change, along with several retrospective studies investigating the use of nitrofurantoin in patients with impaired renal function, prompted the Beers Criteria update. A review article attempted to uncover the clinical evidence supporting this change, but it found minimal applicable results. To date, only 3 retrospective trials have looked at patients with impaired renal function who were treated with nitrofurantoin.

The authors concluded that nitrofurantoin appears to be safe in patients with impaired renal function. Another retrospective study conducted in investigated the safety and efficacy of nitrofurantoin in outpatient Danish women to build upon the results of the previous study and attempt to elicit rates of rare serious adverse events. Overall treatment ineffectiveness, which was defined as receipt of a second antibiotic within 1 month of the study drug, did not differ between groups Although a higher rate of ineffectiveness was observed as renal function declined, renal impairment was not significantly associated with treatment ineffectiveness.

The risk of adverse reactions was significantly higher in nitrofurantoin patients with impaired renal function compared with trimethoprim patients with impaired renal function adjusted HR for nitrofurantoin 4. The authors concluded that nitrofurantoin may be effective in women with impaired renal function, though a higher rate of adverse events may occur. Medicine Datasheet, Management of suspected bacterial urinary infection in adults.

Edinburgh: SIGN, Adult empirical antimicrobial treatment guidelines. ADHB, NZF v Antibiotics: choices for common infections. Nitrofurantoin-induced pulmonary reaction involving respiratory symptoms: case report. Can J Hosp Pharm ;—5. Antimicrobial resistance data from hospital and community laboratories. ESR, Are our patients kidneys any different? Make a comment:. Consult official guidance on the appropriate use of antibiotics when prescribing nitrofurantoin.

Published 12 February Related content Managing common infections: guidance for primary care Urinary tract infection: diagnostic tools for primary care. Brexit Check what you need to do. Explore the topic Alerts and recalls. Is this page useful? Maybe Yes this page is useful No this page is not useful. Thank you for your feedback.

Report a problem with this page. What were you doing? Nevertheless, nitrofurantoin is prescribed often in patients with mild-to-moderate renal impairment. Patients with end-stage renal disease were excluded. When treatment failure was defined as an emergency department visit or hospital admission for a UTI within 14 days, a similar pattern — slightly higher failure rates with nitrofurantoin than with quinolones, regardless of renal function — again was noted. However, this analysis did not address whether drug side effects are more common when nitrofurantoin is used in patients with renal impairment versus those without.

Singh N et al. Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women. CMAJ Jun 16;