A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to:
a. begin antibiotic therapy after urine culture and sensitivity results are available.
b. give prophylactic antibiotics for 6 weeks after the acute infection has cleared.
c. initiate immediate treatment with broad-spectrum antibiotics.
d. refer the patient for intravenous antibiotics and hospitalization.
ANS: A
Patients with renal calculi are more likely to have complicated urinary tract infections that have less predictable microbiologic etiologies. Because the symptoms are mild, it is important first to obtain a culture and sensitivity to assist with antibiotic selection. If symptoms worsen, a broad-spectrum antibiotic may be started until sensitivity information is available. Intravenous antibiotics are indicated for severe pyelonephritis. Long-term prophylaxis is not indicated unless this patient develops frequent reinfection.
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