RT Journal Article
T1 Nitrofurantoin-induced liver injury: long-term follow-up in two prospective DILI registries.
A1 Bessone, Fernando
A1 Ferrari, Antonella
A1 Hernandez, Nelia
A1 Mendizabal, Manuel
A1 Ridruejo, Ezequiel
A1 Zerega, Alina
A1 Tanno, Federico
A1 Reggiardo, Maria Virginia
A1 Vorobioff, Julio
A1 Tanno, Hugo
A1 Arrese, Marco
A1 Nunes, Vinicius
A1 Tagle, Martin
A1 Medina-Caliz, Inmaculada
A1 Robles-Diaz, Mercedes
A1 Niu, Hao
A1 Alvarez-Alvarez, Ismael
A1 Stephens, Camilla
A1 Lucena, M Isabel
A1 Andrade, Raul J
K1 Autoimmune-like hepatitis
K1 Drug-induced liver injury
K1 Hepatotoxicity
K1 Nitrofurantoin
AB Nitrofurantoin is a synthetic antibiotic that is recommended as first-choice treatment for uncomplicated urinary tract infections. The prescription of this drug has increased dramatically, especially in Latin American countries. We described the demographics, clinical characteristics, biochemical features, and outcome of nitrofurantoin-induced liver injury. We analyzed 23 cases from the Latin American DILI Network (LATINDILI) and the Spanish DILI Registry. Causality was assessed with the RUCAM and RECAM scale. Of the 23 DILI cases included in our series, 96% patients were women, and the mean age of the whole cohort was 61 years. The median time of drug exposure was 175 days (interquartile range [IQR] 96-760), with 11 patients who were prescribed nitrofurantoin for more than six months. Hepatocellular damage was the most frequent pattern of liver injury (83%), and nearly half of the patients had an asymptomatic presentation (52%). Neither death nor liver transplantation was documented in this series. Overall, 65% of the patients (n = 15) presented with positive autoantibody titres. The median time to resolution was 81 days (IQR 57-141), and 15 patients (83%) recovered within six months. Five patients (22%) developed nitrofurantoin-induced autoimmune-like hepatitis (NI-AILH), of whom two were characterized by a persistent increase in transaminases that required immunosuppressive treatment to achieve normalization of liver enzymes. Clinicians who prescribe nitrofurantoin should be aware that patients who had taken nitrofurantoin for a long term may be at risk of developing nitrofurantoin-induced autoimmune-like hepatitis.
YR 2022
FD 2022-11-22
LK http://hdl.handle.net/10668/19631
UL http://hdl.handle.net/10668/19631
LA en
DS RISalud
RD Apr 10, 2025