A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before
A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with: a. gemifloxacin.
b. ciprofloxacin.
c. azithromycin.
d. TMP/SMX.
B
Fluoroquinolones are effective in treatment of UTIs that are resistant to other antibiotics. Because this patient recently completed a course of TMP/SMX, the NP can assume that the bacterium causing the infection is resistant to TMP/SMX. Gemifloxacin is not indicated for UTI, but ciprofloxacin is. Azithromycin is not a fluoroquinolone.
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