The man who died after taking antibiotics did not warn of the danger

A disabled man who died of lung disease caused by long-term use of an antibiotic should have been warned of the danger, a health expert has found.

In a recently released report, Deputy Health and Disability Commissioner Carolyn Cooper found several health professionals missed opportunities to make sure the man understood the risk of taking the antibiotic nitrofurantoin for months more than six.

The man, who had been paralyzed for several years before the accident, was given the drug for the first time in 2017 to treat common bladder infections by a specialist at the community hospital’s spine center.

He took nitrofurantoin for about 28 months over three years, before dying of pulmonary fibrosis – a rare side effect of long-term antibiotic use.

Subsequently, his wife complained about this care against several health care providers, including a chiropractor at a spine center, a medical center, her GP, a chemist and a department of urology in a community hospital elsewhere.

“In completing this research, I agree and support his desire to prevent any preventable death that may be caused by the negative effects of nitrofurantoin,” Cooper said.

He found health professionals “share responsibility for missed opportunities” to warn men of harm.

“While I am very concerned that none of the health care providers who cared for the man made sure he understood the risks, I believe that no one person or service has a lot of responsibility,” he said.

“All health care providers who had a role in ordering and administering nitrofurantoin to that man should have assessed whether he knew the long-term risk at the appropriate time,” and that this did not happen.”

A specialist at the spine center told the HDC that he “remembered” notifying the patient in July 2017 of the injury, but admitted there was no record of this conversation.

Other providers – including a GP and urology registrar at another hospital – continued to offer it in the coming months and years until 2019.

The man’s wife told HDC that after taking nitrofurantoin for about six to eight months, her husband developed a mild and dry cough, but since they had unaware that this may be related to nitrofurantoin, they did not raise any concerns about this. at that time.

The government’s drug safety agency, Medsafe, first announced the risk of adverse lung effects associated with the use of nitrofurantoin back in 2002, and again in 2012.

However, the GP said he was unaware of the risk of lung damage at the time.

“If I had known about the serious long-term side effects of these medications, I certainly would have done a risk/benefit analysis.”

The secretary of urology said that when he saw a patient, he was doing an unsupervised clinical procedure with limited time for serious medical discussions or great support.

“I was disappointed when I heard [Mr A’s] death. Any part that I have played in this process is very frustrating for me. I feel responsible for this and I am very upset that my interaction with him was not the small moment that was needed to change his path from an early death.

“This explanation is difficult for me to accept, however, it is tempered by the fact that I was not the doctor who started the prophylaxis using nitrofurantoin, and also my knowledge that the patient was and under the continuous supervision of a urologist in private practice [another region].”

A pharmacy consultant told the HDC that the pharmacy should have informed the patient of the potential risk, but admitted there was a feeling among some in the profession that “time pressure and cost ” doesn’t allow that type of element.

The pharmacist told the HDC: “As a community pharmacist, you have to trust that the doctor has made a conscious decision to start a patient on long-acting nitrofurantoin after weighing the risks and benefits, especially if they they’re taking a lot of short-term courses.”

Cooper said the complaint revealed that some doctors were unaware of the potential for serious lung damage from long-term use of nitrofurantoin.

“It shed light on a very important issue and encouraged the necessary reforms and education to reduce the chances of a similar situation in the future,” he said.

In response to the crisis, relevant donors had already made changes.

These include a request made by the pharmacy to the Pharmacy Safety Association to request the distribution of relevant information to all community pharmacists.

The backbone is creating an information document that will be shared with the Royal New Zealand College of General Practitioners (RNZCGP).

The medical center has done an examination of all the patients given this medicine for diagnosis and to make sure that the side effects are repeated in them.