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CASE REPORT
Nitrofurantoin immune-mediated drug-induced liver injury: a serious complication of a commonly prescribed medication
  1. Theresa Hydes1,
  2. Mark Wright1,
  3. Eleanor Jaynes2,
  4. Kathryn Nash1
  1. 1Department of Hepatology, University Hospital Southampton, Southampton, UK
  2. 2Department of Histology, University Hospital Southampton, Southampton, Hampshire, UK
  1. Correspondence to Dr Theresa Hydes, therasa{at}doctors.org.uk

Summary

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.

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