Interstitial Lung Disease Secondary to Long-Term Nitrofurantoin Use

Patient: Male, 88-year-old Final Diagnosis: Interstitial lung disease Symptoms: Chronic dyspnea Medication: Nitrofurantoin Clinical Procedure: None Specialty: Pulmonology OBJECTIVE: Adverse events of drug therapy BACKGROUND: Interstitial lung disease, also known as diffuse parenchymal lung disease, is a group of diseases that affects the interstitium of the lungs and can lead to progressive fibrosis of the lungs. The potential causes of inter-stitial lung disease are broad and includes infection, malignancy, autoimmune/connective tissues diseases, inhaled substances, and certain medications. One of the medications that can cause interstitial lung disease is nitrofurantoin. CASE REPORT: A 88-year-old man with recurrent urinary tract infections was treated with long-term nitrofurantoin prophylactic therapy. He took 100 mg of nitrofurantoin on a daily basis for over 10 years as prophylactic therapy for recurrent urinary tract infections, and subsequently developed chronic respiratory failure requiring supplemental oxygen. Chest radiography and high-resolution computed tomography imaging were performed and revealed pulmonary fibrosis consistent with interstitial lung disease. CONCLUSIONS: Although nitrofurantoin is one of the most commonly used antibiotics in the treatment of urinary tract infections and is often considered a relatively safe medication, long-term use can lead to the development of inter-stitial lung disease.