•Ms. Ember Creek is a 30 y/o female who presents to the clinic with concerns of “burning when I pee.”
•She has no significant past medical history. She reports increased frequency, urgency, and painful urination. She admits to foul smelling urine.
•Exam shows:
•Vitals: Temp 98.6F; BP 120/80; RR 16; HR 80
•Positive suprapubic tenderness.
•There is no CVA tenderness to either side.
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•You suspect a UTI, specifically an uncomplicated cystitis
•(Remember, be as specific in your diagnoses as possible)
•You want to propose a treatment plan beyond “start antibiotics”
•You know that the Infectious Disease Society of America has guidelines on this topic and might (i.e. will) have specific recommendations
•You do a quick Google search…
•International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update
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•Which of the following is not a guideline recommended option to treat an uncomplicated cystitis in this woman?
•A) Nitrofurantoin
•B) Trimethoprim-Sulfamethoxazole
•C) Fosfomycin
•D) Ciprofloxacin
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