Rosh Internal Medicine Boost Practice Exam

Which antibiotic is most appropriate for a previously healthy woman presenting with symptoms of a urinary tract infection?

1. Ciprofloxacin

2. Fosfomycin

3. Nitrofurantoin

4. Penicillin

The correct answer is: Ciprofloxacin

Ciprofloxacin is a fluoroquinolone antibiotic known for its effectiveness against a broad range of bacteria, including those commonly responsible for urinary tract infections (UTIs). In previously healthy women presenting with uncomplicated UTIs, fluoroquinolones like ciprofloxacin are often considered due to their wide spectrum of activity, good tissue penetration, and ease of administration. While other options may also be effective, ciprofloxacin is typically reserved for cases where other first-line treatments are not appropriate or have failed, mainly due to concerns about resistance patterns or specific patient factors. In the case of uncomplicated UTIs in a previously healthy population, studies showing better efficacy and broader coverage support ciprofloxacin being a suitable first-line option. Nitrofurantoin and fosfomycin are also effective for UTIs, particularly for uncomplicated cases. However, nitrofurantoin has limitations in terms of renal function and resistance issues, and fosfomycin is often considered when first-line agents are contraindicated or unavailable. Penicillin does not provide the broad-spectrum coverage required for effective treatment of UTIs caused by common pathogens. It is not typically used for this indication due to a narrower spectrum of activity against the bacteria involved in UTIs. Therefore, cip