vyseerx
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julia 28 years old artist comes to her obstetritian for first trimester care. she complains of burning micturition, adn increased frequency. on examination there is mild suprapubic tenderness. her history is unremarkable except for the fact that she takes insulin for diabetes mellitus.she is febrile and complained chills.tenderness at the costovertebral angle is noted. urinalysis has shown 100.000 colonyforming units of a single organism. she does not smoke , does consume alcohol occassionally and denied sick contacts. she owns a honda , and likes mercedes. she has two dogs at her home. what is the the most appropriate treatment for sally?
a.ciprofloxacillin for 3 days
b.ciprofoloxacilin for 7 days
c.ciprofloxacilin for 14 days
d.TMP+SMX for 3 days
e.TMP+SMX for 7 days
f.TMP+SMX for 14 days
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vyseerx
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| TONY PAUL
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c.ciprofloxacilin for 14 days
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| TONY PAUL
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sorry I' wrong with cipro..she is pregnant
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| medvishu22
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i go for TMP+SMX for 14-21 days .kyu shekhar bhai
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i m doctor from india immigrated to usa preparing for step -2
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| vyseerx
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you got it right vishal, congrats
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vyseerx
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| ayeshah_l
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y not for 3 days??
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| mkodumagulla
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In pregnancy Sulpha drugs are contra.Nitrofurantoins are indicated. First time UTI I think Cipro for 3 days should be ok.
Please correct me if wrong.
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| vyseerx
Forum Guru
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in pregnancy sulpha drugs are NOT CONTRA-INDICATED. on the contrary , QUINOLONES ARE . so , trimethoprim-sulpha , for 14 days is the correct answer. now, why not for 3 days? since it is not simple cystitis.!
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vyseerx
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| mkodumagulla
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Thanks for the explonation.
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| goneskuba
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sulfa drugs are contraind in ppl with G6PD def
shaking chills, fever, suprapubic pain, cva tenderness all = PYELONEPHRITIS
Rx-1-TMP-SMX 14-21 days IV
2-Nitrofuratoin
3-cephalexin
prohylaixis with nitrofurantoin when discharged
biggest complication would be PML(premature labor)...as UTI itself can bring about contraxns
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| goneskuba
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hope that helps
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