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Nitrofurantoin renal function — GPhC CRA MCQ

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HardInfectionsNitrofurantoin renal functionGPhC CRA

A prescription for nitrofurantoin modified-release 100 mg twice daily for 3 days is presented for an 82-year-old woman with cystitis symptoms. Her latest eGFR, recorded yesterday, is 26 mL/min/1.73 m². She is otherwise stable. What is the most appropriate action?

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Correct answer: B — Query the prescription and request an alternative antibiotic

Nitrofurantoin is unlikely to achieve adequate urinary concentrations and has increased toxicity risk in significant renal impairment. An eGFR of 26 mL/min/1.73 m² is below the usual threshold for routine use. The pharmacist should query the prescription and request a suitable alternative based on local guidance and susceptibility where available. Taking the medicine with food would not address the renal issue.

Reference: BNF; NICE CKS