CHAPTER 44 – ANTIBACTERIAL DRUGS

Question 1

Jane, a 22 year old woman, has presented with a 4-day history of dyspraxia, frequency and urinary urgency. On questioning she is indicated that she has not experienced any pain nor has she noted any blood in her urine. She indicated that she had recently become sexually active and confirmed that she was not pregnant. An abdominal examination was conducted (no supra pubic tenderness noted) temperature was normal (37.2*C) and a mid-stream urine specimen was collected for dipstick analysis. The diagnosis of acute cystitis was made and Jane was commenced on Trimethoprim 300mg orally, daily for 3 days. In addition, she was advised to obtain from a pharmacy Ural sachets and to take 1-2 sachets dissolved in a glass of water 3-4 times daily for 3 days.

Answer 1

Jane, a 22 year old woman, has presented with a 4-day history of dyspraxia, frequency and urinary urgency. On questioning she is indicated that she has not experienced any pain nor has she noted any blood in her urine. She indicated that she had recently become sexually active and confirmed that she was not pregnant. An abdominal examination was conducted (no supra pubic tenderness noted) temperature was normal (37.2*C) and a mid-stream urine specimen was collected for dipstick analysis. The diagnosis of acute cystitis was made and Jane was commenced on Trimethoprim 300mg orally, daily for 3 days. In addition, she was advised to obtain from a pharmacy Ural sachets and to take 1-2 sachets dissolved in a glass of water 3-4 times daily for 3 days.

Question 2

1. Explain why the dipstick analyses were positive for leukocyte esterase, nitrates and blood.

Answer 2

These positives are associated with an UTI.

Question 3

2. What is the most likely organism involved in community-acquired uncomplicated UTI?

Answer 3

Jane has most likely acquired a certain bacteria.

70-90% of uncomplicated UTIs are caused by E.coli.

Question 4

3. Discuss the mechanism of action of Trimethprim and the rationale for its use in this situation

Answer 4

It works by killing sensitive bacteria. It eliminates bacteria that cause urinary tract infections hence why this drug has been chosen.

Question 5

4. Explain why Jane was advised to obtain Ural satchels from the pharmacy

Answer 5

.Ural is used to help relieve the painful, burning sensation due to it being a urinary alkaliniser. So it will assist also in relieving Jane’s symptoms but it wont cure the cause (that’s what the antibiotics are for)