Nitrofurantoin in renal impairment and upper UTI — GPhC CRA MCQ
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Correct answer: A — Urgent medical assessment for possible upper UTI or sepsis
Nitrofurantoin is unsuitable for suspected upper UTI because it does not achieve adequate tissue levels, and reduced eGFR further limits use. Fever, rigors and loin pain suggest pyelonephritis or sepsis risk. The pharmacist should refer urgently rather than suggest an uncomplicated lower-UTI regimen.
Reference: BNF; NICE CKS