Nitrofurantoin for urinary tract infections is contraindicated in patients with less than 60 mL/min creatinine clearance


Use of Nitrofurantoin for urinary tract infections is contraindicated in patients with less than 60 mL/min creatinine clearance. Healthcare professionals should be aware of a patient’s current renal function when prescribing, especially for elderly patients.

Nitrofurantoin is an oral antibiotic used in the treatment of urinary tract infections. The antibacterial efficacy in this infection depends on the renal secretion of Nitrofurantoin into the urinary tract. In patients with renal impairment, renal secretion of Nitrofurantoin is reduced, which can result in treatment failure. Nitrofurantoin is therefore contraindicated in those with less than 60 mL/min creatinine clearance.

Since January 2012, MHRA ( Medicines and Healthcare Products Regulatory Agency ) has received reports of 11 patients with renal impairment who had experienced inappropriate prescription of Nitrofurantoin, some of which resulted in treatment failure.

Reminder for healthcare professionals

a) Be aware of current renal function when prescribing Nitrofurantoin, especially for elderly patients;

b) The product information should be consulted in relation to established risks of Nitrofurantoin, which include: pulmonary toxicity; hepatic toxicity; peripheral neuropathy; and contraindications in G6PD deficiency and acute porphyria;

c) Guidance on the appropriate use of antibiotics and the prevalence of resistance should be considered when prescribing Nitrofurantoin. ( Xagena )

Source: Drug Safety Update 2013; vol 7; issue 1: A3

XagenaMedicine_2013



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