ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2015
Kidney function and the use of nitrofurantoin to treat urinary tract infections in older women.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed.
- Dosage adjustments in renal impairment among medical ward patients: ChatGPT® and DeepSeek® models' effectiveness in assessing those adjustments.Exploratory research in clinical and social pharmacy · 2026Article
- Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review.Clinical pharmacokinetics · 2025Review
- Quality of Antibiotic Prescribing for Outpatient Cystitis in Adult Females.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Review
- Antibiotic Selection and Duration for Catheter-Associated Urinary Tract Infection in Non-Hospitalized Older Adults: A Population-Based Cohort Study.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Variation in Antibiotic Treatment Failure Outcome Definitions in Randomised Trials and Observational Studies of Antibiotic Prescribing Strategies: A Systematic Review and Narrative Synthesis.Antibiotics (Basel, Switzerland) · 2022Review
- Adherence to guideline recommendations for urinary tract infections in adult women: a cross-sectional study.Primary health care research & development · 2021Observational
- A rare case of nitrofurantoin-induced acute lung injury.Clinical case reports · 2020Article
- Low antimicrobial resistance in general practice patients in Rotterdam, the city with the largest proportion of immigrants in the Netherlands.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Lower Urinary Tract Infections: Management, Outcomes and Risk Factors for Antibiotic Re-prescription in Primary Care.EClinicalMedicine · 2019Article
- Nitrofurantoin and fosfomycin for resistant urinary tract infections: old drugs for emerging problems.Australian prescriber · 2019Review
- Risk of adverse outcomes following urinary tract infection in older people with renal impairment: Retrospective cohort study using linked health record data.PLoS medicine · 2018Article
- Leveraging Antimicrobial Stewardship in the Emergency Department to Improve the Quality of Urinary Tract Infection Management and Outcomes.Open forum infectious diseases · 2018Article
- Antimicrobial Pharmacotherapy Management of Urinary Tract Infections in Pediatric Patients.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2018Review
- Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults.Infectious disease clinics of North America · 2017Review
- Membrane-Active Hydantoin Derivatives as Antibiotic Agents.Journal of medicinal chemistry · 2017Article
- How Common Are Pulmonary and Hepatic Adverse Effects in Older Adults Prescribed Nitrofurantoin?Journal of the American Geriatrics Society · 2017Article
- Prescribing for patients on dialysis.Australian prescriber · 2016Review
- Low Concordance With Guidelines for Treatment of Acute Cystitis in Primary Care.Open forum infectious diseases · 2015Article
- Nitrofurantoin and older women.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015Article
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Abstract
backgroundThe antibiotic nitrofurantoin is commonly used to treat uncomplicated urinary tract infections. However, when this drug is used by patients with reduced kidney function, its urine concentration may be subtherapeutic.
methodsWe conducted a population-based study of older women (mean age 79 years) in Ontario, Canada, whose estimated glomerular filtration rate was relatively low (median 38 mL/min per 1.73 m(2)) and for whom 1 of 4 antibiotics had been prescribed for urinary tract infection: nitrofurantoin, ciprofloxacin, norfloxacin or trimethoprim-sulfamethoxazole. We assessed 2 measures of treatment failure in the subsequent 14 days: receipt of a second antibiotic indicated for urinary tract infection and hospital encounter (emergency department visit or hospital admission) with a urinary tract infection. We repeated the analysis for older women with relatively high estimated glomerular filtration rate (median 69 mL/min per 1.73 m(2)).
resultsThe baseline characteristics of the 4 antibiotic groups were similar. Relative to nitrofurantoin, the other antibiotics (including ciprofloxacin) were associated with a lower rate of treatment failure among women with relatively low estimated glomerular filtration rate (for ciprofloxacin v. nitrofurantoin: second antibiotic prescription, 130/1989 [6.5%] v. 516/3739 [13.8%], odds ratio [OR] 0.44, 95% confidence interval [CI] 0.36-0.53; hospital encounter, 21/1989 [1.1%] v. 95/3739 [2.5%], OR 0.41, 95% CI 0.25-0.66). However, a similar risk of treatment failure with nitrofurantoin was also observed among women with relatively high estimated glomerular filtration rate. The results were consistent in multiple additional analyses.
interpretationIn this study, the presence of mild or moderate reductions in estimated glomerular filtration rate did not justify avoidance of nitrofurantoin.
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