A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile
A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective?
a. A 14-day course of amoxicillin with clavulanic acid (Augmentin)
b. A 7-day course of ciprofloxacin (Cipro)
c. A single dose of fosfomycin (Monural)
d. A 3-day course of trimethoprim/sulfamethoxazole (Bactrim)
ANS: D
Short-course therapy is recommended for uncomplicated, community-acquired lower urinary tract infections. The short course is more effective than a single dose, and compared with longer course therapies, it is less costly, has fewer side effects, and is more likely to foster compliance. Amoxicillin with clavulanic acid is a second-line drug used for pyelonephritis. Fosfomycin is a second-line drug and can be useful in patients with drug allergies.
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