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Nitrofurantoin in reduced eGFR — GPhC CRA MCQ

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HardRenal and Hepatic ImpairmentNitrofurantoin in reduced eGFRGPhC CRA

A 34-year-old woman with uncomplicated lower UTI symptoms is prescribed nitrofurantoin modified-release 100mg twice daily for 3 days. Her records show eGFR 38mL/min/1.73m2, no fever, no flank pain and no pregnancy. The urine culture from last month showed multidrug resistance. What is the most appropriate action?

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Correct answer: A — Check appropriateness with the prescriber, noting cautious short-course use may be considered

Nitrofurantoin is usually avoided when eGFR is below 45mL/min/1.73m2, but short-course cautious use may be considered in selected lower UTI cases with resistant organisms and eGFR 30 to 44. The culture history and absence of upper UTI features are important. The pharmacist should check the prescriber has considered renal function and indication.

Reference: NICE NG109; BNF