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Nitrofurantoin prophylaxis renal impairment — GPhC CRA MCQ

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ModerateRenal and Hepatic ImpairmentNitrofurantoin prophylaxis renal impairmentGPhC CRA

A 40-year-old woman with eGFR 28mL/min/1.73m2 is prescribed nitrofurantoin for recurrent lower UTI prophylaxis. She is afebrile and has no loin pain. What is the most appropriate action?

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Correct answer: C — Query the prescription because renal impairment makes long-term nitrofurantoin unsuitable.

Nitrofurantoin efficacy and safety are affected by renal function, and long-term prophylaxis is generally unsuitable in significant renal impairment. The prescription should be checked against current guidance and alternatives considered by the prescriber. Dose escalation would increase adverse-effect risk without resolving the renal issue.

Reference: BNF; NICE CKS