A 19-year-old client with symptoms of recurrent urinary tract infection states that she generally does not finish the prescription given to her for the infection. What medication is the health care practitioner most likely to prescribe for this client?
1. Nitrofurantoin (Furadantin)
2. Trimethoprim-sulfamethoxazole (TMP-SMZ)
3. Fosfomycin (Monurol)
4. Ciprofloxacin (Cipro)
Correct Answer: 3
Rationale 1: Nitrofurantoin is a urinary antiseptic taken for a number of days. The client's problem relates to compliance; therefore, the client needs a medication that can be given in one dose.
Rationale 2: Treatment with trimethoprim-sulfamethoxazole requires a number of days, so it is not appropriate for a client with compliance issues.
Rationale 3: Fosfomycin would be the drug of choice for this client because it is given as a single dose, so compliance is not an issue.
Rationale 4: Ciprofloxacin (Cipro) is effective as a three-day regimen, but with the client's problem with compliance, a medication that can be given in one dose would be a better choice.
Global Rationale: Fosfomycin would be the drug of choice for this client because it is given as a single dose, so compliance is not an issue. The other drugs are taken for a number of days and depend upon the client's compliance.
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