UTI Antibiotic Pregnancy CKD — ESENeph MCQ

Correct answer: C — Give culture-guided oral cefalexin during pregnancy

The best answer is “Give culture-guided oral cefalexin during pregnancy”. NICE includes cefalexin as a pregnancy option when culture supports susceptibility. A urine culture is obtained, response reviewed and upper-tract infection excluded when systemic features are present. “Ciprofloxacin as routine first choice in pregnancy” is less appropriate because fluoroquinolones are avoided when safer effective options are available “No antibiotic because lower UTI is benign in pregnancy” is less appropriate because pregnancy increases pyelonephritis and obstetric risk “Aminoglycoside monotherapy at home without monitoring” is less appropriate because toxicity and administration make this inappropriate for susceptible uncomplicated lower UTI “Single-dose antifungal therapy” is less appropriate because the organism is bacterial and susceptible to cefalexin

Reference: NICE NG109: lower UTI antimicrobial prescribing: https://www.nice.org.uk/guidance/ng109/chapter/Recommendations