Adverse effects of chronic nitrofurantoin therapy in women with recurrent urinary tract infections in an outpatient sett
- PDF / 622,017 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 68 Downloads / 165 Views
ORIGINAL ARTICLE
Adverse effects of chronic nitrofurantoin therapy in women with recurrent urinary tract infections in an outpatient setting Navin N. Maredia1 · Michael J. Fanning1 · Alana L. Christie1 · Bonnie C. Prokesch2 · Philippe E. Zimmern1 Received: 14 August 2020 / Accepted: 18 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To review the frequency of adverse events reported with nitrofurantoin (NF) in perimenopausal and menopausal women on prolonged daily prophylaxis in an outpatient setting. Methods Electronic medical records of women aged 50–95 prescribed NF by 2 primary urology providers for at least 3 consecutive months from 2006 to 2018 were retrospectively reviewed. Demographics, reason for the initiation, dose and duration of therapy, explanation of therapy interruptions, occurrence of adverse events, comorbid conditions, and relevant lab and imaging results were recorded. The number of months on prolonged therapy were summed. Results Of the 221 patients included, 167 (77%) were prescribed 100 mg of NF daily with a mean duration of therapy of 1.5 years. The most common indication for therapy was recurrent urinary tract infection prophylaxis. Breakthrough urinary tract infections developed in 88 (40%) patients on prolonged NF therapy but only 10 were not restarted on NF. Four patients (1.8%) were determined to have pulmonary adverse events and 1 (0.4%) developed elevated liver function tests. Conclusion In peri-menopausal and menopausal women, the risks and benefits of chronic NF therapy should be weighed by the clinician and patient prior to prescribing long term NF. Patients must be educated about the potential NF toxicities and clinically monitored for signs and symptoms of potential adverse events while on chronic NF therapy. Keywords Nitrofurantoin · Recurrent UTI · Urinary tract infection · Perimenopausal and menopausal women
Introduction
* Philippe E. Zimmern [email protected] Navin N. Maredia [email protected] Michael J. Fanning [email protected] Alana L. Christie [email protected] Bonnie C. Prokesch [email protected] 1
Urology Department, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390‑9110, USA
Infectious Disease Department, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390‑9113, USA
2
Urinary tract infections (UTI), the most common bacterial infections in the world, are primarily seen in women with about half experiencing at least one UTI in their lifetime [1, 2]. Symptoms often include urgency, frequency, hesitancy, pelvic pain, and dysuria, and can lead to complicated infections such as pyelonephritis and sepsis. According to a study from Finland, nearly half of women who experience one UTI develop recurrent UTIs (RUTI) [3] with 24% having a recurrence within the first 6 months [4]. As women age, there is increased propensity to develop RUTI due to changes in the hormonal milieu,
Data Loading...
