Maredia Navin N, Fanning Michael J, Christie Alana L, Prokesch Bonnie C, Zimmern Philippe E
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.
World J Urol. 2021 Jul;39(7):2597-2603. doi: 10.1007/s00345-020-03464-w. Epub 2020 Oct 7.
To review the frequency of adverse events reported with nitrofurantoin (NF) in perimenopausal and menopausal women on prolonged daily prophylaxis in an outpatient setting.
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.
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.
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.
回顾门诊环境中接受长期每日预防性使用呋喃妥因（NF）的围绝经期和绝经后女性报告的不良事件发生频率。
回顾性分析2006年至2018年期间由2名泌尿外科初级医疗服务提供者为50 - 95岁女性开具NF且连续至少3个月用药的电子病历。记录人口统计学信息、开始用药原因、治疗剂量和疗程、治疗中断的原因、不良事件的发生情况、合并症以及相关实验室和影像学检查结果。计算长期治疗的月数总和。
纳入的221例患者中，167例（77%）每日服用100 mg NF，平均治疗疗程为1.5年。最常见的治疗指征是预防复发性尿路感染。88例（40%）接受长期NF治疗的患者发生了突破性尿路感染，但只有10例未重新使用NF。4例患者（1.8%）被确定发生肺部不良事件，1例（0.4%）肝功能检查结果升高。
对于围绝经期和绝经后女性，临床医生和患者在开具长期NF处方前应权衡慢性NF治疗的风险和益处。必须对患者进行关于NF潜在毒性的教育，并在慢性NF治疗期间对其进行临床监测，以发现潜在不良事件的体征和症状。
