Chronic nitrofurantoin-induced lung disease.
Jose L Mendez1, Hassan F Nadrous, Thomas E Hartman
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Mayo Clinic Proceedings
|October 11, 2005
Summary
Chronic nitrofurantoin-induced lung disease primarily affects older women, presenting with respiratory symptoms after prolonged use. Discontinuing nitrofurantoin often improves lung disease, with corticosteroids aiding severe cases.
Area of Science:
- Pulmonology
- Pharmacology
- Radiology
Background:
- Nitrofurantoin is commonly prescribed for urinary tract infections.
- Chronic lung disease can be an adverse effect of long-term nitrofurantoin use.
- Understanding the clinical and radiological features is crucial for diagnosis and management.
Purpose of the Study:
- To reassess the clinical and radiological features of chronic nitrofurantoin-induced lung disease.
- To evaluate the clinical outcome of patients with this condition.
Main Methods:
- Retrospective review of medical records of 18 patients diagnosed with chronic nitrofurantoin-induced lung disease.
- Analysis of clinical symptoms, chest radiography, and computed tomography (CT) findings.
- Assessment of treatment outcomes following nitrofurantoin discontinuation and/or corticosteroid therapy.
Main Results:
- The study population comprised predominantly older women (94%) with a median age of 72 years.
- Patients experienced respiratory symptoms (dyspnea, cough) after a median of 23 months of nitrofurantoin therapy.
- Radiological findings included bilateral ground-glass opacities on CT, with some showing subpleural irregular linear opacities and patchy consolidation.
- Discontinuation of nitrofurantoin led to improvement in most patients; 9 received corticosteroid therapy.
Conclusions:
- Chronic nitrofurantoin-induced lung disease typically affects older women with prolonged nitrofurantoin use.
- Clinical presentation includes respiratory symptoms, and radiological features are often nonspecific but include bilateral ground-glass opacities.
- Cessation of nitrofurantoin is key to management, with corticosteroids beneficial for severe cases.
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