Run a search for patients on long-term nitrofurantoin, trimethoprim or other prophylactic antibiotics and give each a short review.
Is there still a reason — how many infections in the last six months? Is the drug and dose one the guideline supports? Has any urine culture since starting shown resistance to it? For nitrofurantoin, what is the renal function, and any breathlessness or cough suggesting lung toxicity? Has a trial off been discussed?
- Infections in the last six months on prophylaxis.
- Guideline drug, dose and formulation.
- Any culture resistant to the current drug.
- Renal function and pulmonary symptoms on nitrofurantoin.
- A planned trial off after 6–12 months.
Why it matters
Long-term prophylaxis is easy to start and rarely stopped.
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