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Lower UTI renal function — GPhC CRA MCQ

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ModerateInfectionsLower UTI renal functionGPhC CRA

A 69-year-old woman presents a prescription for nitrofurantoin 100 mg modified-release twice daily for lower UTI. Her record shows eGFR 32 mL/min/1.73 m² last week and symptoms are uncomplicated. What is the most appropriate alternative?

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Correct answer: B — Query suitability because nitrofurantoin at this renal function needs caution and context

Nitrofurantoin is generally avoided in significant renal impairment, though short-course use may be considered with caution in eGFR 30 to 44 mL/min/1.73 m² for specific lower UTI circumstances. The pharmacist should check local guidance, indication and prescriber rationale before supply. Automatic substitution is not appropriate. Prolonged courses increase toxicity risk.

Reference: NICE NG109; BNF