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A 19-year-old college student comes to the student health service because of a 12-hour history of increased frequency and burning on urination. For the past 6 hours she has felt the need to urinate, but can only produce a "few drops" at each attempt. She is otherwise in good health and had a periodic health maintenance examination just 2 months ago. She does mention that since that check up she has started seeing a new boyfriend and they have recently begun to have intercourse. A urine dip is positive for nitrites. In addition to sending a urine specimen for culture and sensitivity, the most appropriate next step is to:

A. advise the patient that she should abstain from sexual intercourse
B. advise the patient that she should drink increased amounts of cranberry juice to help acidify her
urine
C. advise the patient that she should empty her bladder both before and after intercourse
D. give the patient a prescription for ampicillin tablets
E. tell the patient to return in 2 days when you will have the preliminary results of the urine culture
and its sensitivities

D, just guessing

C?

C ..q from UW also

D.

I think we should treat empirically after culture is withdrawn so answer A
The other choices address the prevention of UTI
Thanks

Correct answer is D

I'm sorry, where did you get this q?
It just doesn't make sense...
1st line treatment of urethritis and/ or cystitis is ceftriaxone, with/without azithromycin, isn't it ?

This patient has classic signs and symptoms of a urinary tract infection (UTI). Symptoms include dysuria, frequency, and urgency. UTIs are common, especially with the onset of sexual relations with a new partner. The most common causes of UTIs include E. coli, Enterococcus, and Proteus. Since the urine dip is positive for nitrites, she should be given a prescription for ampicillin.

It is inappropriate to advise the patient to abstain from sexual intercourse (choice A). Sexual intercourse does not need to be avoided when a patient has a UTI.

Advise the patient that she should drink increased amounts of cranberry juice to help acidify her urine (choice B) and advise the patient that she should empty her bladder both before and after intercourse (choice C) are both suggestions that may be helpful for prevention of future UTIs. However, the patient still needs treatment for her current infection.

UTIs should be treated in order to avoid advancement to pyelonephritis, therefore it is inappropriate to (choice E) tell the patient to return in 2 days when you will have the preliminary results of the urine culture and its sensitivities. If sensitivity returns and the organism is not sensitive to what you prescribe, treatment can be altered.

D.