Nitrofurantoin immune-mediated drug-induced liver injury: a serious complication of a commonly prescribed medication

Abstract

Nitrofurantoin is recommended for first line prophylaxis of recurrent urinary tract infections. Despite a number of side effects it is increasingly prescribed due to its high efficacy, low cost and minimal antimicrobial resistance. Nitrofurantoin-induced immune-mediated liver injury is a particularly serious complication, resulting in both acute hepatic failure and cirrhosis with continued use. We describe the course of two patients who recently presented to our hospital in order to highlight this.