[Liver cirrhosis due to chronic use of nitrofurantoin]

Author(s): Volbeda F, Jonker AM, Vecht J, Groeneveld PH

Affiliation(s): Locatie Sophia, afd. Interne Geneeskunde, Isala Klinieken, Zwolle. frankevolbeda@hotmail.com

Publication date & source: 2004-01-31, Ned Tijdschr Geneeskd., 148(5):235-8.

Publication type: Case Reports; English Abstract

A 74-year-old woman was admitted with jaundice. She was suffering from generalised liver failure with a highly prolonged prothrombin time, a low albumin level and ascites. Further anamnesis revealed that she had been taking nitrofurantoin as a prophylactic agent for recurrent urinary tract infections every day for 5 years. Because of the indications for liver damage due to nitrofurantoin, the drug was discontinued immediately on admission. After withdrawal of nitrofurantoin there was a very gradual clinical and biochemical improvement. Liver biopsies to confirm the diagnosis revealed extensive liver damage with cirrhosis such as may be seen following long-term use of nitrofurantoin. Nitrofurantoin should be prescribed with caution as a prophylactic agent in elderly women and patients with renal dysfunction because the risk of liver damage as a serious side effect of nitrofurantoin is greatly increased in these patients.