A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin
The nurse knows that the best alternative for treating this urinary tract infection is with:
a. cephalexin (Keflex).
b. fosfomycin (Monural).
c. methenamine (Hiprex).
d. nitrofurantoin (Macrodantin).
ANS: C
Methenamine is an excellent second-line drug for this patient and is indicated because of the patient's multiple drug sensitivities. It is safe in pregnancy, and there is no drug resistance. Nitrofurantoin has potential harmful effects on the fetus and should not be used during pregnancy. Single-dose regimens are not recommended in pregnant women. Cephalexin can have cross-reactivity with amoxicillin.
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