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For what condition is Nitrofurantoin specifically contraindicated?
CrCl < 60
MRSA
VRE
ESBL
The correct answer is: CrCl < 60
Nitrofurantoin is specifically contraindicated in patients with a creatinine clearance (CrCl) less than 60 mL/min. This is because nitrofurantoin is primarily eliminated by the kidneys, and in patients with reduced kidney function, the drug can accumulate to toxic levels leading to adverse effects. Therefore, monitoring the renal function of patients before prescribing nitrofurantoin is crucial to ensure its safe and effective use. Options B, C, and D (MRSA, VRE, and ESBL) are incorrect because they do not represent conditions for which nitrofurantoin is contraindicated. Nitrofurantoin is an antibiotic commonly used to treat uncomplicated urinary tract infections caused by susceptible bacteria, but it is not effective against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), or extended-spectrum beta-lactamase (ESBL) producing bacteria.