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Nitrofurantoin renal impairment — GPhC CRA MCQ

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ModerateInfectionsNitrofurantoin renal impairmentGPhC CRA

A 72-year-old woman is prescribed nitrofurantoin 100mg modified-release twice daily for lower UTI. Her latest eGFR is 28mL/min/1.73m2. She has no fever or flank pain. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Query the prescription because renal function may make nitrofurantoin unsuitable

Nitrofurantoin depends on renal secretion into urine and is generally avoided at low eGFR because of reduced efficacy and increased adverse effect risk. The prescriber should review antibiotic choice using renal function and local guidance. Symptoms should also be checked for upper UTI or sepsis.

Reference: BNF; NICE CKS