title: Updated Nitrofurantoin Recommendations in the Elderly: A Closer Look at the Evidence.
abstract: The American Geriatrics Society 2015 Beers Criteria Update Expert Panel has revised its recommendation to avoid use of nitrofurantoin in renal impairment from patients with a creatinine clearance (Clcr) of less than 60 mL/min to those with a Clcr of less than 30 mL/min, based on two retrospective studies that identified the safety and efficacy of nitrofurantoin in this population. This change in recommendation, along with increasing resistance to both sulfamethoxazole/trimethoprim and fluoroquinolones, gave rise to the advantages of nitrofurantoin and may reflect a surge in prescribing among the elderly. The purpose of the manuscript is to provide readers with a brief review of updated evidence to confidently treat older patients with nitrofurantoin.
authors.affiliation: Touro College of Pharmacy, New York, New York, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Hoang
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Salbu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000892:Anti-Infective Agents, Urinary / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D015577:Geriatric Assessment; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000503:physiopathology*; D009582:Nitrofurantoin / Q000009:adverse effects / Q000627:therapeutic use*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000892:Anti-Infective Agents, Urinary; D009582:Nitrofurantoin