Question #12
HG is a 64 year-old female who presents to her primary care doctor with complaints of dysuria and increased urinary frequency. She has a past medical history that includes osteoporosis. She has a sulfa allergy. She is post-menopausal. Due to the low-grade symptoms she is experiencing, the provider orders a urine culture with urinalysis, then tells the patient to increase her water intake and call if symptoms worsen. Two days later the results of the urine culture are back and show E. coli that is sensitive to all drugs it was tested against (see below). The urinalysis is positive for leukocyte esterase, has 9 RBCs and has 155 WBCs. The provider calls the patient and despite increasing water intake the symptoms have persisted. Which of the following would be the best drug to give to this patient?
E. coli sensitive to: amoxicillin-clavulanic acid, piperacillin-tazobactam, cephalexin, ceftriaxone, cefepime, ciprofloxacin, sulfamethoxazole-trimethoprim, nitrofurantoin, and tobramycin
A. Nitrofurantoin
B. Sulfamethoxazole-trimethoprim
C. Ampicillin
D. Ciprofloxacin