Nitrofurantoin Induced Liver Injury - Abstract
Drug induced liver injury is a recognised cause of acute liver failure. A wide
range of drugs have been implicated, of which the most common are Paracetamol and
antibiotics. Nitrofurantoin is a commonly prescribed antimicrobial which may cause liver
injury from either acute or chronic exposure. This complication was thought to occur with
an extremely low incidence; however recent data suggests that it may be significantly
more common.
We present a case of Nitrofurantoin induced liver injury in a 78 year old lady
due to prophylactic use for 12 months with full resolution following withdrawal of the
offending agent.
Discussion and review of the literature includes the low incidence and how this may
be a substantially more regular occurrence than previously described, treatment by
withdrawal of the causative agent and prognosis which is generally good, however
cirrhosis and death have both been reported. The pattern of injury and clinical features
are also reviewed, both of which are extremely variable but may be defined in
relation to acute or chronic features.