Question of the Week # 217

217 )  A 36 year old woman presents to the office complaining of burning urination, urgency and frequency. She denies fever or abdominal pain. She is sexually active with one partner for the past 1 month and her partner always uses condoms.  Her past medical history is significant for peri-partum cardiomyopathy 2 years ago which spontaneously resolved. She recalls that she was treated with furosemide for her peripheral edema at that time however, the drug had to be stopped due to a severe rash. On physical examination, she is afebrile. There is mild supra-pubic tenderness with out any costo-vertebral angle tenderness. Urinalysis reveals bacteriuria and several white blood cells with out any casts. Which of the following is the most appropriate next  step in managing this patient?

A) Admit for Intravenous antibiotics

B) Trimethoprim-Sulfamethoxazole

C) Piperacillin-Tazobactam

D) Moxifloxacin

E) Trimethoprim

5 Responses

  1. B

  2. Sparfloxacin and moxifloxacin achieve considerably lower concentrations in the urine than other quinolones and are not approved for this indication.Since she allergic to furosemode,TMP or SMx can’t be used.

    the toxicities of furosemide include sulfa allergies..Tmp in itself is not a sulfa drug.
    Ans.E

  3. E

  4. E

  5. E

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