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Urinary Tract Infection — SCE Infectious Diseases MCQ

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HardAntimicrobial StewardshipUrinary Tract InfectionSCE Infectious Diseases

A non-pregnant woman with recurrent lower UTI begins methenamine hippurate after the current infection is treated. She routinely uses potassium citrate cystitis sachets. What counselling and review plan follows NICE NG112?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stop alkalinising sachets and review treatment at six months, then annually

Explanation lettering: E = shown as A · D = shown as C · A = shown as D · C = shown as E

E is correct. Methenamine requires acidic urine to generate its antiseptic effect; potassium or sodium citrate alkalinising sachets make it less effective and should be stopped. NICE advises review within six months of starting and annually thereafter, with earlier review if clinically needed. Methenamine is used continuously as an antibiotic-sparing prevention strategy rather than intermittently on symptomatic weeks, and upper-tract symptoms require prompt reassessment rather than merely waiting for a scheduled review.

Reference: NICE NG112: recurrent UTI recommendations: https://www.nice.org.uk/guidance/ng112/chapter/Recommendations