Nitrofurantoin and Chronic Active Hepatitis

as a urinary tract antiseptic. It is estimated that approxi-mately 5 million courses of nitrofurantoin or one of its analogs are given yearly in the United States and Canada (Personal communication, Norwich-Eaton Pharmaceuti-cals, Norwich, New York). Many different side-effects, including fever, leukopenia, hemolytic anemia, pulmo-nary fibrosis, peripheral neuropathy and chplestatic jaun-dice have been described. The reports by Black and asso-ciates (1) and Sharp and associates (2) in this issue focus on the previously rarely recognized syndrome of nitrofu-rantoin-induced chronic active hepatitis. Proof of drug-induced injury has been obtained by the ultimate test of rechallenge in five patients. Thus, there can be no ques-tion of the association of nitrofurantoin and chronic ac-tive hepatitis. The paucity of reports of toxicity in th