PEBC MCQ Infectious Diseases & Immunization question: agents tested on routine screening

PEBC MCQInfectious Diseases & Immunization

AH, 26, is 10 weeks pregnant and has asymptomatic bacteriuria with E. coli susceptible to all agents tested on routine screening. Which antibiotic is most appropriate?

a. Ciprofloxacin 250 mg twice daily for 3 days
b. Trimethoprim-sulfamethoxazole DS twice daily for 3 days
c. Cephalexin 500 mg four times daily for 5 to 7 days
d. No treatment, since she has no symptoms

Show the answer and explanation

Answer: c. Cephalexin 500 mg four times daily for 5 to 7 days

Asymptomatic bacteriuria in pregnancy is screened for and treated because it increases the risk of pyelonephritis and preterm birth. Beta-lactams such as cephalexin or amoxicillin (if susceptible) are preferred; nitrofurantoin is also used but avoided near term. Trimethoprim is a folate antagonist best avoided in the first trimester, and fluoroquinolones are generally avoided in pregnancy. Source: Epp A, Larochelle A et al. SOGC Clinical Practice Guideline No. 250, Recurrent urinary tract infection (J Obstet Gynaecol Can 2010;32:1082); Bugs & Drugs, Asymptomatic bacteriuria in pregnancy (checked 2026).

Common mistake

Not treating asymptomatic bacteriuria in pregnancy.

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