Urgent Care For UTI 4

Question 1

A patient presents with UTI symptoms and reports a sulfa allergy with anaphylaxis. Which antibiotic should be avoided?

Accepted Answer

Trimethoprim-sulfamethoxazole

Answer

TMP-SMX contains sulfamethoxazole, a sulfonamide antibiotic that is contraindicated in patients with sulfa allergy, especially with anaphylaxis history.

Question 2

A 34-year-old woman at 32 weeks gestation develops fever, rigors, and flank pain. Blood cultures are drawn and IV antibiotics are started. Which antibiotic is CONTRAINDICATED due to potential fetal harm?

Accepted Answer

Nitrofurantoin (near term)

Answer

Nitrofurantoin is contraindicated at 36+ weeks gestation due to risk of neonatal hemolytic anemia from immature glutathione pathways.

Question 3

A 55-year-old woman with type 2 diabetes presents with a UTI. She takes metformin. Which antibiotic interaction requires caution if a fluoroquinolone is prescribed?

Accepted Answer

Fluoroquinolones can cause hypoglycemia independently of metformin

Answer

Fluoroquinolones can independently disturb glucose homeostasis, causing both hypoglycemia and hyperglycemia, requiring blood sugar monitoring in diabetic patients.

Question 4

A urine culture grows E. coli with the following susceptibilities: resistant to TMP-SMX and ampicillin, susceptible to nitrofurantoin, ciprofloxacin, and ceftriaxone. The patient has uncomplicated cystitis and no allergies. What is the preferred oral treatment?

Accepted Answer

Nitrofurantoin 100 mg twice daily for 5 days

Answer

Nitrofurantoin is the preferred oral agent for uncomplicated cystitis when susceptible; fluoroquinolones should be reserved to preserve their use for serious infections.

Question 5

Which clinical finding would prompt you to classify a UTI as 'complicated' rather than uncomplicated?

Accepted Answer

Presence of a ureteral stent

Answer

Structural or functional urinary tract abnormalities such as a ureteral stent, indwelling catheter, or obstruction classify a UTI as complicated.

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Urgent Care For UTI 4