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Nitrofurantoin


Presentation

  • The usual presenting symptoms were dyspnoea and non-productive cough which had been present for periods for two weeks to six years (mean, 9.4 months). After cessation of nitrofurantoin therapy, the condition of 32 patients improved.[ncbi.nlm.nih.gov]
  • The patient was treated with nitrofurantoin 3 weeks before presentation and she turned out to have a deficiency of glucose-6-phosphate dehydrogenase.[ncbi.nlm.nih.gov]
  • Two patients who had been taking nitrofurantoin for several years, presented with severe liver failure. In both, the drug had been continued despite evidence of liver injury.[ncbi.nlm.nih.gov]
  • The two middle aged women presented with respiratory symptoms after prolonged treatment with nitrofurantoin.[ncbi.nlm.nih.gov]
  • Drug-induced hepatotoxicity presents in acute (3 in 1 000 000) and chronic (1 in 1500) forms. We present a patient with acute liver failure after 5 days of treatment.[ncbi.nlm.nih.gov]
Pain
  • We describe the case of a 73-year-old woman with a history of chronic low back pain and 2 previous lumbar fusions who presented with complaints of worsening back and leg pain.[ncbi.nlm.nih.gov]
  • In addition, the patient reported fatigue, dyspnea on exertion, pleuritic pain, burning trachea pain, and a cough. Chest X-rays showed bilateral pulmonary disease consistent with nitrofurantoin toxicity.[ncbi.nlm.nih.gov]
  • We describe 2 patients with relatively short exposure to nitrofurantoin who developed non–length-dependent neuropathic pain.[doi.org]
  • Check with your doctor immediately if any of the following side effects occur: More common Changes in facial skin color chest pain chills cough fever general feeling of discomfort or illness hives hoarseness itching joint or muscle pain shortness of breath[mayoclinic.org]
  • […] muscle pain shortness of breath skin rash sudden trouble in swallowing or breathing swelling of the face, mouth, hands, or feet troubled breathing Less Common Black, tarry stools blood in the urine or stools burning, numbness, tingling, or painful sensations[drugs.com]
Disturbance of Growth
  • In the presence of therapeutic levels of nitrofurantoin, even resistant mutants are so disturbed in growth that they are probably unable to become enriched and establish an infection.[ncbi.nlm.nih.gov]
Pleural Effusion
  • A chest radiograph revealed right-sided pleural effusion and basal markings.[ncbi.nlm.nih.gov]
  • Rarely, pleural effusion and/or pulmonary hemorrhage may occur. Diagnosis is made by clinical suspicion and exclusion of other causes of respiratory compromise.[ncbi.nlm.nih.gov]
  • Acute pulmonary reactions are commonly manifested by fever, chills, cough, chest pain, dyspnea, pulmonary infiltration with consolidation or pleural effusion on x-ray, and eosinophilia.[dailymed.nlm.nih.gov]
  • Recurrent pulmonary infiltration and pleural effusion due to nitrofurantoin sensitivity. N Engl J Med, 266 (1962), pp. 1.024 [10.] C. Schoenberger, R.G. Crystal. Drug-induced lung disease. En Updare IV, Harrison's.[archbronconeumol.org]
  • Jones, Pleural effusion: An uncommon manifestation of nitrofurantoin-induced pulmonary injury, Respiratory Medicine Case Reports, 19, (65), (2016) ., Nitrofurantoin, Meyler's Side Effects of Drugs, 10.1016/B978-0-444-53717-1.01159-8, (210-218), (2016)[doi.org]
Nausea
  • A 67-yr-old woman with a history of myocardial infarct was admitted to emergency for marked dyspnea, nonproductive cough, nausea and fever. The thorax X-ray revealed a bilateral alveolar and interstitial infiltration pattern with basal accentuation.[ncbi.nlm.nih.gov]
  • Ten days later, the patient restarted the nitrofurantoin, and she returned to the emergency department after again experiencing sudden intense substernal burning, nausea, vomiting, shivering, and weakness.[ncbi.nlm.nih.gov]
  • Side Effects Nausea , vomiting , loss of appetite, or headache may occur. Take this medication with food to help minimize nausea . If any of these effects persist or worsen, notify your doctor or pharmacist promptly.[webmd.com]
  • Side Effects Nausea, vomiting, loss of appetite, or headache may occur. Take this medication with food to help minimize nausea. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.[webmd.com]
Hepatomegaly
  • Abdominal ultrasound was normal with the exception of a slight hepatomegaly without any lesions, focal or diffuse.[ncbi.nlm.nih.gov]
Leg Pain
  • We describe the case of a 73-year-old woman with a history of chronic low back pain and 2 previous lumbar fusions who presented with complaints of worsening back and leg pain.[ncbi.nlm.nih.gov]
Costovertebral Angle Tenderness
  • Women who required antimicrobial drug treatment for lack of resolution of initial UTI symptoms or for new UTI symptoms of dysuria, frequency, and/or urgency or signs of pyelonephritis (costovertebral angle tenderness—with or without fever) during follow-up[doi.org]
Pruritus
  • Also, angioedema; maculopapular, erythematous, or eczematous eruptions; pruritus; urticaria; anaphylaxis; arthralgia; myalgia; drug fever; and chills have been reported.[dailymed.nlm.nih.gov]
  • ) [ Ref ] Dermatologic Rare (less than 0.01% to 0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome ) Frequency not reported : Transient alopecia, angioedema, maculopapular rash, erythematous rash, eczematous rash, pruritus[drugs.com]
  • Skin: maculopapular, erythematous, or eczematous eruption; pruritus; urticaria; exfoliative dermatitis; Stevens-Johnson syndrome, transient alopecia. Other: hypersensitivity reactions (anaphylaxis), drug fever.[glowm.com]
  • Adverse Reactions Nausea Headache Flatulence Diarrhea Dizziness, drowsiness, amblyopia Acute pulmonary hypersensitivity reaction Pruritus, urticaria Alopecia Fever, chills, malaise Superinfection caused by resistant organisms Overdose Symptoms may include[ebmconsult.com]
Auditory Hallucination
  • An 83-year-old Caucasian woman with Alzheimer's disease developed auditory hallucinations 2 days after intake of two NF tablets (100 mg) daily.[ncbi.nlm.nih.gov]
Headache
  • Side Effects Nausea , vomiting , loss of appetite, or headache may occur. Take this medication with food to help minimize nausea . If any of these effects persist or worsen, notify your doctor or pharmacist promptly.[webmd.com]
  • Side Effects Nausea, vomiting, loss of appetite, or headache may occur. Take this medication with food to help minimize nausea. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.[webmd.com]
  • Speak to your doctor if these don't help with the headaches or the headaches are severe. dizziness or feeling sleepy - if nitrofurantoin makes you feel dizzy, stop what you're doing and sit or lie down until you feel better. 7.[beta.nhs.uk]
Peripheral Neuropathy
  • It is well documented that patients with preexisting renal dysfunction are at increased risk of having nitrofurantoin-induced peripheral neuropathy develop.[ncbi.nlm.nih.gov]
  • Unknown in the obstetric and gynecologic literature is the complication of peripheral neuropathy as an adverse effect.[ncbi.nlm.nih.gov]
  • Nitrofurantoin and peripheral neuropathy: a forgotten problem? Medical Journal of Australia , 174 : 153-154 (2001).[apps.who.int]
  • To investigate the role of skin biopsy in nitrofurantoin peripheral neuropathy. We describe the clinical features and skin biopsies of 2 cases of non-length-dependent small-fiber neuropathy/ganglionopathy attributable to nitrofurantoin.[ncbi.nlm.nih.gov]
  • Neurologic Peripheral neuropathy, which may become severe or irreversible, has occurred. Fatalities have been reported.[dailymed.nlm.nih.gov]
Stroke
  • Eight of the patients had been hospitalized because of various acute diseases (e.g. cerebral stroke). Ten of the patients were subjectively symptomless.[ncbi.nlm.nih.gov]

Workup

Pleural Effusion
  • A chest radiograph revealed right-sided pleural effusion and basal markings.[ncbi.nlm.nih.gov]
  • Rarely, pleural effusion and/or pulmonary hemorrhage may occur. Diagnosis is made by clinical suspicion and exclusion of other causes of respiratory compromise.[ncbi.nlm.nih.gov]
  • Acute pulmonary reactions are commonly manifested by fever, chills, cough, chest pain, dyspnea, pulmonary infiltration with consolidation or pleural effusion on x-ray, and eosinophilia.[dailymed.nlm.nih.gov]
  • Recurrent pulmonary infiltration and pleural effusion due to nitrofurantoin sensitivity. N Engl J Med, 266 (1962), pp. 1.024 [10.] C. Schoenberger, R.G. Crystal. Drug-induced lung disease. En Updare IV, Harrison's.[archbronconeumol.org]
  • Jones, Pleural effusion: An uncommon manifestation of nitrofurantoin-induced pulmonary injury, Respiratory Medicine Case Reports, 19, (65), (2016) ., Nitrofurantoin, Meyler's Side Effects of Drugs, 10.1016/B978-0-444-53717-1.01159-8, (210-218), (2016)[doi.org]

Treatment

  • In participants exposed to nitrofurantoin, chronic treatment was compared with acute treatment using multivariable logistic regression. Treatment failure was compared in three CrCl groups.[ncbi.nlm.nih.gov]
  • We present a patient with acute liver failure after 5 days of treatment. A 69-year-old man admitted for chronic obstructive pulmonary disease exacerbation 5 days into treatment for cystitis with nitrofurantoin.[ncbi.nlm.nih.gov]
  • METHODS: Serial stool samples were collected from patients receiving nitrofurantoin treatment at different timepoints [before treatment (day 1; T1), within 48 h of end of treatment (days 5-15; T2) and 28 days after treatment (days 31-43; T3)], as well[ncbi.nlm.nih.gov]
  • Background There is a paucity of data on the efficacy of nitrofurantoin for the treatment of acute uncomplicated cystitis in regimens shorter than 7 days.[doi.org]
  • Fosfomycin trometamol is a safe and effective alternative for the treatment of cystitis and asymptomatic UTI during pregnancy, and has become, in many countries, the first choice for treatment of any type of cystitis.[ncbi.nlm.nih.gov]

Etiology

  • Clinical course, culture results and pathological evaluation excluded infectious etiologies and were consistent with a drug reaction.[ncbi.nlm.nih.gov]
  • Bronchoalveolar lavage (BAL) may be used to rule out infectious etiologies, and an increase in BAL fluid eosinophils is suggestive of drug-induced toxicity. The acute reaction to nitrofurantoin is believed to be mediated by an immune mechanism.[ncbi.nlm.nih.gov]
  • We describe the clinical history and the autopsy findings in a 51-year-old woman with lung fibrosis of unknown etiology. She had a history of recurrent urinary tract infections, treated with nitrofurantoin for many years.[ncbi.nlm.nih.gov]
  • Here, we present the clinical history and autopsy findings of a 51-year-old woman with a history of lung fibrosis of unknown etiology.[doi.org]
  • The etiologic uropathogen identified in the laboratory database was confirmed in 100% of the chart reviews.[doi.org]

Epidemiology

  • To present three patients in whom long-term exposure to the drug resulted in chronic active hepatitis; and to review the epidemiology, clinical immunology, histopathology, pathogenetic features and treatment of previously reported cases.[ncbi.nlm.nih.gov]
  • This study investigated the molecular epidemiology of the multidrug-resistant efflux gene oqxAB and its contribution to nitrofurantoin resistance by using Escherichia coli isolates originating from patients with UTI (n 205; collected in 2004 to 2013)[ncbi.nlm.nih.gov]
  • Emerging Gram negative resistance to last-line antimicrobial agents fosfomycin, colistin and ceftazidime-avibactam - epidemiology, laboratory detection and treatment implications. Expert Rev Anti Infect Ther 2018;16:289-306.[nps.org.au]
  • Additional studies examining the relationship between prenatal exposure to these antibiotics and birth defects have reported potential fetal risks, whereas other studies have not found such risks among other populations or when using different epidemiologic[acog.org]
Sex distribution
Age distribution

Pathophysiology

  • The case is described, and the literature on the nitrofurantoin pulmonary toxicity syndromes and pathophysiology is reviewed.[ncbi.nlm.nih.gov]
  • Pharmacotherapy: A Pathophysiologic Approach . 6th ed. New York: McGraw-Hill; 2005. 11. Linnebur SA, Parnes BL. Pulmonary and hepatic toxicity due to nitrofurantoin and fluconazole treatment. Ann Pharmacother . 2004;38:612-616. 12.[consultant360.com]

Prevention

  • (via heterocyclic antibiotic ) (via nitrofuran antibiotic ) antiinfective agent A substance used in the prophylaxis or therapy of infectious diseases. antibacterial drug A drug used to treat or prevent bacterial infections.[ebi.ac.uk]
  • The drug is also used for the prevention of recurrent UTI in women. We report a case of nitrofurantoin drug fever associated with its use, following sexual intercourse, for chemoprophylaxis of UTI.[ncbi.nlm.nih.gov]
  • To prevent bladder infections in children, the medication is usually given once or twice a day.[bladder.emedtv.com]
  • During the second and third trimesters, sulfonamides and nitrofurantoins may continue to be used as first-line agents for the treatment and prevention of urinary tract infections and other infections caused by susceptible organisms.[ncbi.nlm.nih.gov]
  • For prophylaxis (prevention) of urinary tract infection, you should take one tablet at bedtime for up to 6 months.[inhousepharmacy.vu]

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