Acute pulmonary toxicity to nitrofurantoin

Nitrofurantoin-induced pulmonary toxicity: A case report and review of the literature

“…The package insert of nitrofurantoin does warn against chronic, subacute or acute pulmonary hypersensitivity reactions that may occur and describes them briefly [18]. However, these symptoms are well-described in the literature, which contains many reports of acute cases of pulmonary toxicity in patients receiving therapy with nitrofurantoin [2][3][4][5][6][7][8][9]. Indeed, significant side effects from the use of nitrofurantoin have been reported since the 1960s, and these include a spectrum of doseindependent lung disease [2][3][4][5][6][7][8][9].…”

“…Acute reactions occur in approximately 1 in 5000 patients after first exposure and are thus qualified as rare. They are more common in middle-aged or elderly female patients or female patients with a structural abnormality of the genitourinary tract who are likely to have recurrent urinary tract infections [7,11].…”

“…However, these symptoms are well-described in the literature, which contains many reports of acute cases of pulmonary toxicity in patients receiving therapy with nitrofurantoin [2][3][4][5][6][7][8][9]. Indeed, significant side effects from the use of nitrofurantoin have been reported since the 1960s, and these include a spectrum of doseindependent lung disease [2][3][4][5][6][7][8][9]. The acute reaction is thought to represent a hypersensitivity reaction that often resolves upon drug withdrawal, whereas in the chronic form, nitrofurantoin has been reported to cause a reaction reflecting an allergic or toxic response.…”

“…These showed that nitrofurantoin has been associated with acute, subacute and chronic pulmonary adverse reactions [2][3][4][5][6][7][8][9]. The first case of acute pulmonary toxicity to nitrofurantoin demonstrating a clear cause-and-effect relationship by intentional rechallenge with the drug was reported by Israel and Diamond in 1962 [10].…”

Nitrofurantoin-Induced Pulmonary Reaction Involving Respiratory Symptoms: Case Report

“…The patient had a 6-day history of nonproductive cough and dyspnea before presenting to the hospital with hypoxia and had received a total of 11 days of nitrofurantoin therapy at the time of presentation. Early presentations of respiratory symptoms secondary to nitrofurantoin therapy have been reported 4,14,15 ; however, this appears to be one of the earliest reported presentations of BOOP secondary to nitrofurantoin. The patient was also taking esomeprazole before admission; however, this drug has not been associated with pulmonary adverse effects.…”