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Urinary Tract Infection (UTI) — MRCGP AKT MCQ

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HardInfectious DiseasesUrinary Tract Infection (UTI)MRCGP AKTUKMLAPARAPSA

A non-pregnant adult has recurrent UTI despite behavioural measures, vaginal oestrogen where appropriate and a trial of single-dose antibiotic prophylaxis. The urinary tract has been adequately assessed. Which non-antibiotic alternative to daily prophylactic antibiotics may be considered?

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Correct answer: D — Methenamine hippurate with advice about alkalinising products

The best answer is “Methenamine hippurate with advice about alkalinising products”. NICE advises considering methenamine hippurate as an alternative to daily antibiotic prophylaxis after earlier preventive steps have not been adequate. Urinary alkalinising products containing potassium or sodium citrate reduce its effectiveness and should be avoided. Treatment is reviewed, and specialist advice is required in specified higher-risk situations.

Reference: NICE NG112: Recurrent UTI antimicrobial prescribing: https://www.nice.org.uk/guidance/ng112/chapter/Recommendations