Abstract

Urinary tract infections are one of the most common bacterial infections, especially in women. Due to the increasing multidrug resistance of pathogens, treatment options are becoming narrower and older antibiotics such as nitrofurantoin are more widely used. The aim of the study was to assess for which urinary tract infections nitrofurantoin is prescribed and whether prescribing of nitrofurantoin differed in patients depending on age or renal insufficiency.
The study is based on the healthcare claims and prescription data of the Estonian Health Insurance Fund. The patients diagnosed with urinary tract infections were evaluated for concomitant renal insufficiency and antibiotics use.

Nitrofurantoin was used somewhat less frequently in the elderly than in younger patients (38% vs 45%, p <0.001). Patients with renal insufficiency were more likely to be prescribed antibiotics other than nitrofurantoin (72% vs 28%, p <0.001). Nitrofurantoin was prescribed for the treatment of pyelonephritis in 14% of the cases and to men in 11% of the cases of diagnosed urinary tract infections.
Overall, nitrofurantoin was predominantly prescribed as recommended, however, due to the lack of efficacy, it should not be used in men and in patients with renal insufficiency, pyelonephritis and urethritis. Although serious adverse reactions are rare with nitrofurantoin, caution should be exercised, especially in patients with risk factors and with prolonged use.