Case 1 of 10InfectiousUrogenital (e.g., cystitis, pyelonephritis)
A 30-year-old female who works as a high-level executive presents to you with symptoms of UTI. This is the 8th episode she has had in the past 1 year. She has followed all precautionary methods and still has developed the symptoms. Her last dose of antibiotics was 6 weeks ago. She is frustrated as its interfering with her ability to work. She wants to know if anything can be done to prevent recurrence of symptoms.
Question 1 of 29
What would be your management plan for the current symptoms?
Select 1. (0 / 1 selected)
100%
AStart empiric nitrofurantoin without sending a culture, since she has had 8 UTIs this year and the diagnosis is clinically obvious
BSend a urine culture & sensitivity, then start empiric oral therapy while awaiting results (nitrofurantoin 100 mg PO BID x5 days, OR TMP-SMX 160/800 mg PO BID x3 days if likely susceptible, OR fosfomycin 3 g PO single dose), adjust per culture, and encourage hydration plus short-term phenazopyridine for symptom relief if not contraindicated
CStart empiric ciprofloxacin 500 mg PO BID x7 days immediately without sending a urine culture, since her symptoms are classic for UTI
DRefer her for admission and empiric IV antibiotics given the frequency of her recurrences
EWithhold any antibiotic until the urine culture and sensitivity results return in 48-72 hours, given she was on antibiotics only 6 weeks ago
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