Holmberg L, Boman G, Böttiger L E, Eriksson B, Spross R, Wessling A
Am J Med. 1980 Nov;69(5):733-8. doi: 10.1016/0002-9343(80)90443-x.
Reports on adverse reactions to nitrofurantoin today are common in Sweden and constitute 10 to 12 percent of all incoming reports. We present an analysis of 921 reports of adverse reactions received by the Swedish Adverse Drug Reaction Committee during the period 1966--1976. The two largest groups consist of reports of acute pulmonary reactions (43 percent) and allergic reactions (42 percent). The remaining reports fall into any of four smaller groups, chronic pulmonary reactions, liver damage, blood dyscrasias or neuropathy. Acute pulmonary and acute allergic reactions in all aspects are very similar and carry the characteristics of an acute hypersensitivity reaction. The increasing number of reports--even in relation to sales figures--would be best explained by a continuous sensitization. Chronic pulmonary reactions (interstitial pneumonitis) afflict older patients, often after prolonged treatment with relatively small doses. We suggest that these reactions are elicited by a toxic mechanism. Seventy-one percent of all reactions were severe enough to cause the patient's hospitalization; only 1 percent was fatal. The risk of an adverse reaction varies with sex and age, increases with age and is higher in women than in men. The time has come for a re-evaluation of nitrofurantoin and its role in the treatment of urinary tract infections.
如今在瑞典，关于呋喃妥因不良反应的报告很常见，占所有收到报告的10%至12%。我们对瑞典药物不良反应委员会在1966年至1976年期间收到的921份不良反应报告进行了分析。最大的两个类别是急性肺部反应报告（43%）和过敏反应报告（42%）。其余报告分属四个较小的类别，即慢性肺部反应、肝损伤、血液系统疾病或神经病变。急性肺部反应和急性过敏反应在各方面都非常相似，具有急性超敏反应的特征。报告数量不断增加——即使与销售数字相比——最好的解释是持续致敏。慢性肺部反应（间质性肺炎）多见于老年患者，通常是在长期使用相对小剂量药物治疗之后。我们认为这些反应是由毒性机制引发的。所有反应中有71%严重到足以导致患者住院；只有1%是致命的。不良反应的风险因性别和年龄而异，随年龄增长而增加，女性高于男性。现在是重新评估呋喃妥因及其在治疗尿路感染中的作用的时候了。
