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Antibiotic choice in CKD — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentAntibiotic choice in CKDGPhC CRA

A 76-year-old woman with eGFR 24 mL/min/1.73 m2 is prescribed nitrofurantoin MR 100 mg twice daily for recurrent dysuria. She also has fever and new confusion. What is the most appropriate action?

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Correct answer: A — Refer urgently and query nitrofurantoin suitability

The renal impairment makes nitrofurantoin unsuitable in many circumstances, and fever with confusion suggests systemic infection. This is not a straightforward lower UTI presentation for routine community management. Urgent clinical assessment and antibiotic review are needed.

Reference: BNF; NICE CKS