skip to main content

UTI in Pregnancy — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAntimicrobial StewardshipUTI in PregnancySCE Infectious Diseases

A 28-year-old woman presents with acute cystitis symptoms. She is 28 weeks pregnant. Urine dipstick shows leucocytes ++ and nitrites +. MSU is sent. While awaiting culture, what is the most appropriate empirical antibiotic?

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

Reveal the answer and explanation

Correct answer: D — Nitrofurantoin 100 mg MR BD for 7 days (safe in second trimester; avoid near term ≥36 weeks)

UTI in pregnancy requires treatment due to risk of progression to pyelonephritis and preterm labour. Nitrofurantoin is recommended by NICE for UTI in the second trimester. It should be avoided in the first trimester (theoretical risk of teratogenicity based on animal data) and near term (≥36 weeks) due to risk of neonatal haemolysis. Trimethoprim is avoided in the first trimester (folate antagonist). Fluoroquinolones are contraindicated throughout pregnancy. Treatment duration in pregnancy is 7 days (longer than non-pregnant 3-day courses). Asymptomatic bacteriuria also requires treatment in pregnancy.

Reference: NICE NG109 2018 – UTI; BNF 2024 – Nitrofurantoin in pregnancy