skip to main content

Uncomplicated cystitis — MCCQE Part 1 MCQ

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

HardDysuriaUncomplicated cystitisMCCQE Part 1

A healthy nonpregnant 28-year-old has dysuria and frequency without fever, flank pain, vaginal symptoms or urinary abnormality. Renal function is normal and local resistance data are unavailable. Which empiric regimen is preferred?

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

Reveal the answer and explanation

Correct answer: C — Nitrofurantoin 100 mg orally twice daily for 5 days

This is acute uncomplicated cystitis without features of pyelonephritis. Nitrofurantoin 100 mg twice daily for five days is a first-line regimen when renal function is adequate. TMP-SMX can also be appropriate when the organism is known susceptible or local resistance is sufficiently low, which the stem does not establish. Fluoroquinolones should be reserved because of collateral harm and resistance. Routine culture is not required before treating a typical first episode, though recurrence or atypical features change that approach.

Reference: IDSA/ESCMID, Uncomplicated Cystitis Guideline, https://www.idsociety.org/practice-guideline/uncomplicated-cystitis-and-pyelonephritis-uti; Alberta Health Services, Fluoroquinolone Stewardship, https://www.albertahealthservices.ca/assets/info/asm/if-asm-as-fluoroquinolones.pdf