Pulmonary Fibrosis Due to Nitrofurantoin Therapy: A Case Report

Abstract

We report the case of a patient with pulmonary fibrosis, developed as an adverse reaction to nitrofurantoin therapy received for totally 6 months for the prevention of recurrent urinary tract infections. Chest X-ray and CT scan revealed extensive elements of interstitial pulmonary fibrosis. After diagnosis, administration of nitrofurantoin was immediately stopped; and specific prolonged therapy with low-dose corticosteroids per os and inhaled steroids were administered. The patient responded successfully both clinically and biochemically and possible digestive system side effects were prevented through the administration of gastroprotection medication. For the prevention of urinary tract infection, the patient received well tolerated therapy with fosfomycin which was further continued as a prophylactic agent.

Drug-Induced Interstitial Lung Disease from a Misdiagnosed Infection

“…2 Nitrofurantoin is commonly used to treat UTIs. [3][4][5] It is usually well tolerated and is the only safe antibiotic in pregnancy. 1 Nitrofurantoin-induced interstitial lung disease (NIILD) is seen in <1% of patients.…”

“…3 With rising bacterial resistance, nitrofurantoin is increasingly used to treat UTIs. [4][5] Although NIILD is rare, nitrofurantoin should only be used in a proven UTI. To minimize the risk of NIILD and bacterial resistance, prophylactic treatment should not exceed 6 months.…”