Adverse effects of chronic nitrofurantoin therapy in women with recurrent urinary tract infections in an outpatient setting

• Published in: World journal of urology Vol. 39; no. 7; pp. 2597 - 2603
• Main Authors: Maredia, Navin N., Fanning, Michael J., Christie, Alana L., Prokesch, Bonnie C., Zimmern, Philippe E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2021; Springer Nature B.V
• Subjects: Adverse events; Aged; Aged, 80 and over; Ambulatory Care; Anti-Infective Agents, Urinary - administration & dosage; Anti-Infective Agents, Urinary - adverse effects; Antibiotics; Demography; Disease prevention; Dosage; Electronic medical records; Female; Humans; Medicine; Medicine & Public Health; Menopause; Middle Aged; Nephrology; Nitrofurantoin; Nitrofurantoin - administration & dosage; Nitrofurantoin - adverse effects; Oncology; Original Article; Patients; Prophylaxis; Recurrence; Recurrent infection; Retrospective Studies; Urinary tract; Urinary tract diseases; Urinary tract infections; Urinary Tract Infections - drug therapy; Urogenital system; Urology; Urinary tract infection; Nitrofurantoin; Recurrent UTI; Perimenopausal and menopausal women
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-020-03464-w

Purpose To review the frequency of adverse events reported with nitrofurantoin (NF) in perimenopausal and menopausal women on prolonged daily prophylaxis in an outpatient setting. Methods Electronic medical records of women aged 50–95 prescribed NF by 2 primary urology providers for at least 3 consecutive months from 2006 to 2018 were retrospectively reviewed. Demographics, reason for the initiation, dose and duration of therapy, explanation of therapy interruptions, occurrence of adverse events, comorbid conditions, and relevant lab and imaging results were recorded. The number of months on prolonged therapy were summed. Results Of the 221 patients included, 167 (77%) were prescribed 100 mg of NF daily with a mean duration of therapy of 1.5 years. The most common indication for therapy was recurrent urinary tract infection prophylaxis. Breakthrough urinary tract infections developed in 88 (40%) patients on prolonged NF therapy but only 10 were not restarted on NF. Four patients (1.8%) were determined to have pulmonary adverse events and 1 (0.4%) developed elevated liver function tests. Conclusion In peri-menopausal and menopausal women, the risks and benefits of chronic NF therapy should be weighed by the clinician and patient prior to prescribing long term NF. Patients must be educated about the potential NF toxicities and clinically monitored for signs and symptoms of potential adverse events while on chronic NF therapy.