A 76 year old debilitated man with history of advanced dementia lives in an extended care facility. He has a history of recurrent Urinary tract infections which develop every six months with mild fever, frequency of micturition and urinary incontinence. In the past, his urine cultures revealed E.coli > 100,000 colonies on several occassions. He has no indwelling Foley catheter and he is only placed on diapers. His vital signs are temperature of 98.6, HR 88, RR 18 and a BP of 130/84. A nurse practioneer has routinely ordered a urinalysis which revealed positive leucoesterase and nitrite. This was followed by a urine culture that revealed 100,000 colonies of E.coli. The nurse is concerned about this finding and calls you for appropriate management.
What is the appropriate treatment?
A. Cystoscopy and Intra-venos pyelogram
B. Continuous low dose antibiotics for prevention of recurrent UTIs
C. Catheterize and irrigate the Bladder daily
D. Intravenos antibiotics with broad spectrum coverage
E. No need of treatment as this is colonization
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