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Nitrofurantoin prophylaxis renal function — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentNitrofurantoin prophylaxis renal functionGPhC CRA

A patient aged 81 takes nitrofurantoin 50 mg at night for recurrent UTI prophylaxis. Their eGFR is now 38 mL/min/1.73 m² and they report tingling in the feet. What is the most appropriate alternative?

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Correct answer: D — Refer for review of prophylaxis, renal suitability and possible neuropathy

Long-term nitrofurantoin requires review, especially in reduced renal function and with possible peripheral neuropathy. Reduced renal function may impair efficacy and increase adverse-effect risk. New neurological symptoms should not be ignored. Adding another antibiotic without review is not appropriate.

Reference: BNF; MHRA Drug Safety Update