Long-term nitrofurantoin: an analysis of complication awareness, monitoring, and pulmonary injury cases.
drug-related side effects and adverse reactions
general practice
nitrofurantoin
prescription drug monitoring programs
urology
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
2021
2021
Historique:
received:
12
05
2021
accepted:
23
06
2021
pubmed:
20
8
2021
medline:
20
8
2021
entrez:
19
8
2021
Statut:
epublish
Résumé
Long-term nitrofurantoin (NF) treatment can result in pulmonary and hepatic injury. Current guidelines do not outline the type or frequency of monitoring required for detection of these injuries. To assess 1) awareness of NF complications among prescribers; 2) monitoring practice; and 3) to describe the pulmonary sequelae of NF-related complications. Evaluation of prescribing habits by questionnaires and review of GP databases, and case-note review in secondary care. The following study procedures were undertaken: 1) an electronic questionnaire was distributed to prescribers, interrogating prescribing and monitoring practices, and awareness of complications; 2) an analysis was undertaken (June-July 2020) of NF monitoring among GPs in the local clinical commissioning group (CCG); and 3) a case review was carried out of patients diagnosed with NF-induced interstitial lung disease (NFILD) at the interstitial lung disease (ILD) centre (2014-2020). A total of 125 prescribers of long-term NF responded to the questionnaire (82.4% GPs; 12.0% urologists). Many were unaware of the potential for liver (42.4%) and lung (28.0%) complications; 40.8% and 52.8% never monitored for these, respectively. Only 53.3% of urologists believed themselves responsible for arranging monitoring, while nearly all GPs believed this to be the prescriber's responsibility (94.2%). One-third of all responders considered current NF can cause marked or irreversible lung complications and there is currently a shortfall in awareness and monitoring. Existing monitoring guidelines should be augmented.
Sections du résumé
BACKGROUND
BACKGROUND
Long-term nitrofurantoin (NF) treatment can result in pulmonary and hepatic injury. Current guidelines do not outline the type or frequency of monitoring required for detection of these injuries.
AIM
OBJECTIVE
To assess 1) awareness of NF complications among prescribers; 2) monitoring practice; and 3) to describe the pulmonary sequelae of NF-related complications.
DESIGN & SETTING
METHODS
Evaluation of prescribing habits by questionnaires and review of GP databases, and case-note review in secondary care.
METHOD
METHODS
The following study procedures were undertaken: 1) an electronic questionnaire was distributed to prescribers, interrogating prescribing and monitoring practices, and awareness of complications; 2) an analysis was undertaken (June-July 2020) of NF monitoring among GPs in the local clinical commissioning group (CCG); and 3) a case review was carried out of patients diagnosed with NF-induced interstitial lung disease (NFILD) at the interstitial lung disease (ILD) centre (2014-2020).
RESULTS
RESULTS
A total of 125 prescribers of long-term NF responded to the questionnaire (82.4% GPs; 12.0% urologists). Many were unaware of the potential for liver (42.4%) and lung (28.0%) complications; 40.8% and 52.8% never monitored for these, respectively. Only 53.3% of urologists believed themselves responsible for arranging monitoring, while nearly all GPs believed this to be the prescriber's responsibility (94.2%). One-third of all responders considered current
CONCLUSION
CONCLUSIONS
NF can cause marked or irreversible lung complications and there is currently a shortfall in awareness and monitoring. Existing monitoring guidelines should be augmented.
Identifiants
pubmed: 34407964
pii: BJGPO.2021.0083
doi: 10.3399/BJGPO.2021.0083
pmc: PMC9447296
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2021, The Authors.
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