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UTI in late pregnancy — GPhC CRA MCQ

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HardInfectionsUTI in late pregnancyGPhC CRA

A 33-year-old woman who is 38 weeks pregnant presents a prescription for nitrofurantoin for cystitis. She has no fever, eGFR is normal, and the urine culture shows sensitivity to nitrofurantoin. What is the most appropriate alternative?

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

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Correct answer: A — Query with the prescriber because nitrofurantoin near term may be unsuitable

Nitrofurantoin may be used in pregnancy for lower UTI, but use near term can be unsuitable because of neonatal haemolysis risk. At 38 weeks, the pharmacist should check the prescriber’s rationale and consider alternatives guided by culture and local policy. Ciprofloxacin is not a routine pregnancy alternative for cystitis. Untreated UTI in pregnancy also carries risk, so prescriber review should be prompt.

Reference: BNF; NICE CKS