Question
A 24-year-old female with fever and chills came to causality. Gives history of urinary urgency and dysuria. Urine examination confirmed acute lower urinary tract infection and urine sample given for culture and sensitivity. (
- (a) List two antibiotic groups which can be used to start therapy. ( 1 mark(s)
- (b) Write the mechanism of action, other uses and adverse effects of any one group. ( 3 mark(s)
- (c) List any two antibiotic groups which is contra-indicated in a pregnant lady with urinary tract infection. ( 1 mark(s)
- (d) Name two drugs which is given for chemoprophylaxis. 1 mark(s)
Answer
a) Two antibiotic groups to start therapy Fluoroquinolones (e.g. Ciprofloxacin) and Nitrofurantoin (appropriate for uncomplicated lower UTI) — or Cotrimoxazole, pending culture results.
b) One group in detail — Fluoroquinolones MOA: inhibit bacterial DNA gyrase and topoisomerase IV, blocking DNA replication — bactericidal. Other uses: gastroenteritis, respiratory tract infections, typhoid fever. Adverse effects: tendinopathy/tendon rupture, cartilage damage in developing joints, QT prolongation, lowered seizure threshold.
c) Antibiotic groups contraindicated in pregnancy Fluoroquinolones (cartilage/joint damage risk) and Tetracyclines (fetal tooth/bone deposition, hepatotoxicity) — both avoided regardless of the specific indication.
d) Drugs for chemoprophylaxis Nitrofurantoin and Cotrimoxazole — low-dose, given for recurrent UTI prophylaxis.