In the case described in this video, an expert opinion was demanded from a general physician (GP) and a rheumatologist. The doctor who treated the patient was criticized by GP for not repeating liver function tests after the first abnormal alanine transaminase (ALT) result and assuming that the raised levels were due to a fatty liver. It was confirmed by the rheumatologist that the raised ALT and rash were indeed consistent with the patient's use of nitrofurantoin.
The expert GP and rheumatologist’s findings confirmed that if the doctor had not assumed that the raised ALT was due to a fatty liver, nitrofurantoin could have been stopped a year earlier. The case was deemed to be indefensible and it was settled for a low sum. Clinicians should consider and share information about the medication burdens, side effects, risks and benefits with patients, particularly if a drug is prescribed…
