Nitrofurantoin (NF)-induced adverse effects have been reported frequently, although NF seems to be a first line treatment for lower urinary infections according to the last E.U. and U.S. guidelines. However its use in psychiatric patients should be reviewed with a great caution. In these cases the use of penicillin is therefore sometimes more appropriate, although the total antibiotic consumption rises. Because of NF use, a dose adjustment because of its adverse events (hallucinations) is also possible and cooperation with clinical pharmacist is beneficial in these cases. What do you think?
http://www.ncbi.nlm.nih.gov/pubmed/25123143
I agree with your suggestions.
It is good to see preventative thinking is still alive and well
Good luck Matej
John
Tx John!
sometimes are deviations from the guidelines logical and should be done in respect to the last guidelines
Regards,
Matej
This is true Dr.stuhec
Nitrofurantoin should be avoided in geriatric patients in general not only in psychiatric patients.
Tx Hani!
Yes, i assume also your opinion. Nitrofurantoin is used very often according to the European and American guidelines, however especially in elderly psychiatric patients its use should be done by great caution! Maybe i will write one letter to the editor to the lastest guidelines, because it is particularly important question.
Best,
Mathew
Anti-infective NITROFURANTOIN is listed on the updated Beers list as potentially toxic for older adults. Drugs on this list may not be suitable for older patients. I have attached the list for your review.
Jan Vinita White thanks for this criteria, i also use them in my daily work. In Europe we have Priscus list, where also nitrofurantoin is updated. However, many clinicians do not use these lists and nitrofurantoin is still widely prescribed in many countries.
As clinical pharmacist in psychiatry we also noticed some adverse events with nitrofurantoin and theredore i suggest to avoid it and use another drugs, (e.g. norfloxacin or penicilines where it is possible).
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