Pulmonary Reaction to Nitrofurantoin

Reversible interstitial lung disease with prolonged use of nitrofurantoin: Do the benefits outweigh the risks?

“…The incidence has been estimated to be anywhere from 1 in 550 to 1 in 5400 individuals. [3] Acute toxicity is nearly 10 times more common than chronic. [4] Toxicity can occur at relatively small doses, and does not appear to be dose-related.…”

“…Although relatively rare, nitrofurantoin is one of the most common causes of drug-induced pulmonary disease. [123] Nitrofurantoin induced pulmonary toxicity may manifest as acute or chronic interstitial pneumonia, pulmonary hemorrhage, bronchoconstriction, anaphylaxis, and pleural effusion. Knowledge of such adverse effects is essential for the early recognition and withdrawal of the drug.…”

Dyspnea, Dysphonia, and Cough

“…2,3 The etiology is unclear; the leading theory suggests that chronic airway inflammation leads to the disease. 2,5 The nodules typically progress slowly and are often asymptomatic, with most found incidentally on computed tomography (CT) scan. 2,5 The nodules typically progress slowly and are often asymptomatic, with most found incidentally on computed tomography (CT) scan.…”

“…4 There is no gender predilection, with the majority of patients presenting during the sixth decade of life, although children as young as 5 years of age have been diagnosed with TPO. 2,6 Treatment for TPO is typically supportive but also includes diagnosing and treating other underlying conditions that may exacerbate TPO, such as asthma, allergic rhinitis, and chronic obstructive pulmonary disease. However, patients with moderate to severe disease may present with chronic cough, hoarseness, dyspnea, hemoptysis, or recurrent respiratory infections.…”

“…2,5 The nodules typically progress slowly and are often asymptomatic, with most found incidentally on computed tomography (CT) scan. 2 Three patients with this rare condition presented to the senior author. 2,6 Treatment for TPO is typically supportive but also includes diagnosing and treating other underlying conditions that may exacerbate TPO, such as asthma, allergic rhinitis, and chronic obstructive pulmonary disease.…”