Nitrofurantoin for UTI Flashcards
Against which organisms is nitrofurantoin effective?
The majority of urinary pathogens. E. coli, E. faecalis, Klebsiella species, Enterobacter species, Staphylococcus species.
What are the side effects of nitrofurantoin?
Pulmonary reactions (acute and chronic), nausea, anorexia, hypersensitivity, peripheral neuropathy, blood disorders.
What symptoms call for discontinuation of nitrofurantoin therapy?
Fever, chills, cough, chest pain, dyspnoea.
Describe UTIs in pregnancy.
May be asymptomatic and require prompt treatment to prevent progression to acute pyelonephritis. Penicillins and cephalosporins are suitable.
Why do UTIs in children require prompt treatment?
To avoid renal scarring.
What monitoring is required for nitrofurantoin?
Liver function and pulmonary symptoms in long term therapy, especially in the elderly. Discontinue if deterioration in renal function.
In what groups should a specimen or urine be collected and cultured before starting antibacterial therapy for UTI?
Men, pregnant women, children under 3 years, patients with suspected upper UTI, complicated or recurrent infection, if resistant organisms are suspected, if dipstick testing gives a positive test for leucocyte esterase or nitrate, if clinical symptoms not consistent with results of dipstick.
How should nitrofurantoin be taken?
With or just after food or a meal.
What important counselling point is important with nitrofurantoin?
May discolour urine but this is harmless.
