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Nitrofurantoin borderline eGFR — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentNitrofurantoin borderline eGFRGPhC CRA

A 64-year-old man with eGFR 33mL/min/1.73m2 is prescribed nitrofurantoin for suspected lower UTI. He has no fever, flank pain or systemic symptoms. The prescriber asks whether it can be supplied. What is the most appropriate alternative?

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Correct answer: C — Check current guidance and query suitability because renal function is borderline

Nitrofurantoin use depends on renal function and indication; low eGFR can reduce urinary concentrations and increase toxicity risk. Some short-course use may be permitted at eGFR 30 to 44mL/min/1.73m2 in selected cases depending on guidance, but the pharmacist should verify appropriateness. It is not suitable for suspected upper UTI.

Reference: BNF; NICE CKS