September/2005

ANSWER 1 =B

DISCUSSION: The patient has an uncomplicated urinary tract infection. A recent review article on the “Diagnosis and Management of Uncomplicated Urinary Tract Infections” (http://www.aafp.org/afp/20050801/451.html) have suggested that “studies in the last decade have focused on the treatment length of standard therapies. A study11 comparing a three-day course of ciprofloxacin (Cipro) 100 mg twice daily, ofloxacin (Floxin) 200 mg twice daily, and trimethoprim-sulfamethoxazole (TMP-SMX; Bactrim, Septra) 160/800 mg twice daily, found that all three had comparable efficacy in managing uncomplicated UTI. Another study12 comparing a short course (three days) of ciprofloxacin (100 mg twice daily) with the more traditional seven-day course of TMP-SMX (160/800 mg twice daily), and nitrofurantoin (Furadantin) (100 mg twice daily) found that ciprofloxacin had superior bacteriologic eradication rates after short-term follow-up (four to six weeks).” Choice B is the best answer and common knowledge may not serve you well since the published evidence supports that ciprofloxacin for 3 days is better in terms of eradicating the urosepsis than seven days of TMP/SMX.