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Nitrofurantoin low eGFR — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentNitrofurantoin low eGFRGPhC CRA

A 76-year-old woman with uncomplicated lower UTI symptoms has eGFR 26 mL/min/1.73m2. A prescription for nitrofurantoin is sent electronically. What is the most appropriate alternative?

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Correct answer: D — Contact the prescriber to consider an alternative based on renal function and sensitivities

Nitrofurantoin efficacy and safety are affected by renal function, and low eGFR can make it unsuitable depending on severity and duration. The prescriber should consider local antimicrobial guidance, renal function and culture where relevant. Urinary alkalinisers do not treat bacterial infection. Pharmacists should not substitute antibiotics without authority.

Reference: BNF; NICE CKS