Abstract
In the UK, prophylactic use of nitrofurantoin is recommended in weomen who have 3 or more UTI per year.1 Reported cases of nitrofurantoin-induced pulmonary toxicity are limited and the exact mechanism of chronic nitrofurantoin induced lung reaction is unclear.
We retrospectively reviewed 10 cases of nitrofurantoin-induced pulmonary fibrosis diagnosed in last 8 years at our ILD service. We reviewed patient demographics, time to presentation, lung function and imaging characteristics.
The mean age of our patient cohort is 80 years and all were female. The mean time to presentation from prescription was 17 months. 7 out of 10 patients had CT findings of ground glass opacity and traction bronchiectasis. 4 patients were treated with prednisolone.
The patients in this series improved symptomatically with or without steroid following cessation of nitrofurantoin therapy, but irreversible changes in the chest imaging may contribute to long term morbidity.
In England, the national trend for prescribing nitrofurantoin has gone up significantly in the last 5 years. This is reflected on the total of 378,438 nitrofurantoin prescription items in October 2020 in comparison to 233,044 prescription items in October 2016.2
Cautious counselling should be undertaken prior to nitrofurantoin prescription regardless of renal function.
References:
1. www.bnf.nic.org.uk/treatment summary/urinary-tract-infections.html
2. openprescribing.net
Figure: Summary table of the salient findings
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA2374.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021