PEBC MCQ Infectious Diseases & Immunization question: drug allergies and normal kidney function

PEBC MCQInfectious Diseases & Immunization

ML, 32, healthy and not pregnant, has had dysuria, frequency and urgency for 2 days without fever, flank pain or vaginal discharge. She has no drug allergies and normal kidney function. Which treatment is most appropriate?

a. Amoxicillin 500 mg three times daily for 3 days
b. Cephalexin 500 mg four times daily for 14 days
c. Ciprofloxacin 500 mg twice daily for 7 days to cover resistant organisms
d. Nitrofurantoin 100 mg twice daily for 5 days

Show the answer and explanation

Answer: d. Nitrofurantoin 100 mg twice daily for 5 days

For acute uncomplicated cystitis in non-pregnant women, first-line options are nitrofurantoin 100 mg twice daily for 5 days, TMP-SMX DS twice daily for 3 days where local E. coli resistance is acceptable, or fosfomycin 3 g once. Fluoroquinolones are reserved because of collateral damage and serious adverse effects, amoxicillin alone has high E. coli resistance, and 14 days of cephalexin is longer than needed. Source: Alberta Health Services Bugs & Drugs, Urinary tract infection in adults (bugsanddrugs.org, checked 2026); AMMI Canada position statement on antimicrobial stewardship in UTI (2020); nitrofurantoin (Macrobid) product monograph (DPD, checked 2026).

Common mistake

Using a fluoroquinolone for simple cystitis.

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