A 65-year-old previously healthy man with benign prostatic hypertrophy presents with fever, malaise, and painful urination. On physical exam, he has right costovertebral angle tend... A 65-year-old previously healthy man with benign prostatic hypertrophy presents with fever, malaise, and painful urination. On physical exam, he has right costovertebral angle tenderness and a temperature of 37.7 °C. Rest of physical exam is essentially negative. Which of the following is the most appropriate therapy? A. 7-day outpatient course of trimethoprim-sulfa B. 10-day outpatient course of ciprofloxacin C. 10-day outpatient course with moxifloxacin D. Inpatient treatment with ceftriaxone
Understand the Problem
The question is asking about the appropriate therapy for a 65-year-old man presenting with symptoms suggestive of a urinary tract infection or pyelonephritis. We will need to analyze the patient's presentation and the provided answer choices to determine the best treatment option based on current clinical guidelines.
Answer
10-day outpatient course of ciprofloxacin
The final answer is B. 10-day outpatient course of ciprofloxacin
Answer for screen readers
The final answer is B. 10-day outpatient course of ciprofloxacin
More Information
The patient's symptoms suggest acute pyelonephritis, an infection of the kidneys generally treated with a fluoroquinolone such as ciprofloxacin, especially for outpatient treatment in otherwise healthy individuals.
Tips
Common mistakes include underestimating the severity of the infection and selecting trimethoprim-sulfa, which may be insufficient for upper urinary tract infections like pyelonephritis.