Nitrofurantoin
Summary
Persistence. It cannot be excluded that nitrofurantoin is persistent, due to the lack of data.
Bioaccumulation. Nitrofurantoin has a low potential to bioaccumulate.
Toxicity. It cannot be excluded that nitrofurantoin is toxic, due to the lack of data.
Risk. Nitrofurantoin is considered to have a low environmental risk, both for eukaryotes (including fish) and bacteria (including risk of selection for antibiotic resistance), even if use were to increase significantly in Sweden.
This hazard summary information comes from Fass. The risk comes from the report by Goodpoint.
For antibiotics in general, it is recommended that these pharmaceuticals are used as restrictively as possible without jeopardise the patient's health.
Detailed information
Fass environmental information
Fass environmental information for Furadantin (nitrofurantoin) from Viatris (downloaded 2022-12-19).
Hazard
Persistence: No data.
Bioaccumulation: Log Kow of -0,47 (unknown method).
Toxicity: No data.
Risk
Risk of environmental impact of nitrofurantoin cannot be excluded, due to the lack of environmental toxicity data.
Apart from data for bioaccumulation, there is no environmental information for nitrofurantoin on fass.se (2022-12-19). It is voluntary for manufacturers to provide information about environmental impact on fass.se.
Comparison with ciprofloxacin and trimethoprim
Both ciprofloxacin and trimethoprim are included in Region Stockholm's table of pharmaceuticals with risk for negative environmental impact according to the environmental program 2017–2021. Ciprofloxacin and trimethoprim are found in Swedish wastewater treatment plants in concentrations that are likely to select for antibiotic resistance. Risks associated with large emissions of ciprofloxacin to the environment in manufacturing abroad have been detected.
Nitrofurantoin is considered to have a low environmental risk, both for eukaryotes (including fish) and bacteria (including risk of selection for antibiotic resistance), even if use were to increase significantly. From an environmental perspective, the overall scientific support for replacing both ciprofloxacin and trimetroprim with nitrofurantoin is therefore strong.
References
- Fass.se för vårdpersonal.
- Larsson DG. Pollution from drug manufacturing: review and perspectives. Philos Trans R Soc Lond B Biol Sci. 2014;369:(1656).
- Förteckning över miljöbelastande läkemedel med åtgärdsförslag framtagen inom ramen för SLL:s miljöprogram 2017–2021.
- Jämförande miljöriskbedömningar av möjliga ersättningssubstanser för substanser på Region Stockholms förteckning över miljöbelastande läkemedelssubstanser 2017–2021. Rapport Goodpoint 2017.
Author: Health and Medical Care Administration, Region Stockholm