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Nitrofurantoin at term — GPhC CRA MCQ

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HardClinical TherapeuticsNitrofurantoin at termGPhC CRA

A 30-year-old woman presents with a prescription for nitrofurantoin 100 mg modified-release capsules twice daily for three days for a UTI. She is currently 36 weeks pregnant. What is the most appropriate action?

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Correct answer: B — Contact the prescriber as nitrofurantoin should be avoided at term due to the risk of neonatal haemolysis

Nitrofurantoin should be avoided at term (from 36 weeks) as it may produce neonatal haemolysis if used close to delivery. The BNF advises avoiding nitrofurantoin at term. The prescriber should be contacted to discuss an alternative antibiotic. Trimethoprim is also not ideal in the first trimester (folate antagonist) but may be considered later in pregnancy; cefalexin may be a suitable alternative at this stage.

Reference: BNF; NICE NG109 UTI in Pregnancy