Expectations Length: A minimum of180 words, not including references or attachme

Expectations
Length: A minimum of180 words, not including references or attachments
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Case 3
18 yo female presents with fever, dysuria, and frequency for about 2 days. She reports being 12 weeks pregnant. Denies any nausea or vomiting. She reports she is allergic to Penicillin.
Diagnosis: Urinary Tract Infection in Pregnancy
Discuss what are the potential treatments for this patient’s diagnosis.
Pregnant women are frequently prone to having urinary tract infection due to physiologic and immunologic changes that take place during pregnancy. Pregnancy itself is a state of relative immunocompromise due to the growing fetus. Moreover, the decreased bladder capacity causes frequency of urination, thus increasing the risk of UTI. This condition is treated with antibiotic therapy after identifying the causative agent obtained from urine culture result. The need to treat UTI prevents potential consequences that usually requires hospitalization. Initial treatment for UTI in pregnancy consists of second or third generation cephalosphorins as well as broad-spectrum antibiotics as alternatives (Habak & Griggs Jr., 2023). Hydration and antipyretics are also recommended in the management of fever.
What antibiotic/s should be given for this patient’s diagnosis?
Safety is the main consideration in choosing antimicrobials during pregnancy. Prior to initiation of antibiotics, it is important to confirm the causative organism to ensure that the prescribed medication is effective based on sensitivity. Penicillins (Amoxicillin and Ampicillin) and cephalosphorins (Cephalexin, with the exception of Ceftriaxone) are the first-line treatment recommended in pregnancy. While these antimicrobials can move across the placenta, they are not known to harm unborn babies.
How long should you prescribe the chosen antibiotic?
Traditionally, short-course antibiotic therapy was practiced, however was shown to be not long enough to completely eradicate the infection (Ghouri & Hollywood,2020). It is essential to complete a seven-day course of antibiotic therapy for adequate treatment. While there are conflicting evidence as to whether pregnant patients should be treated with shorter courses of antibiotic, it is important that the course length of antibiotics is in line with the recommended seven days therapy unless new evidences emerge.
What teaching would you give this patient on the prescription?
Adherence to prescribed antibiotic should be firmly emphasized not only for the purpose of treating UTI but also for the prevention of antimicrobial resistance. As the provider, I will emphasize the responsible use of antibiotic therapy by educating the pregnant patient about the benefits and risks associated with antimicrobial use. Patient is advised to follow up after 2 weeks of completion of treatment for repeat urinalysis and cultures to determine if there are further management necessary. Moreover, counseling on prevention measures should be incorporated in pre-natal visits so pregnant women will appreciate the controllability of this infection rather than rely on medical solution. Through this, pregnant women will adopt practices that will facilitate good health not only for themselves but also for their unborn child.
5. Write out a correct prescription for the antibiotic you are going to prescribe for this patient. (Be sure to include all elements needed for a correct prescription)
As mentioned, the patient reported allergy from Penicillin so I will prescribe her cephalosphorins which has the same efficacy in treating UTI in pregnancy. With her being symptomatic as evidenced by elevated temperature, I will write her a prescription for:
Name: Jane Doe
DOB: 09/21/1986
Rx: Cephalexin (Keflex) 500mg
Sig: 1 tablet twice daily PO for 7 days
Disp: #14 (fourteen)
Refills: 0
Provider: Charma Dalope Date: 09/21/2023
References:
Ghouri, F., Hollywood, A. (2020). Antibiotic prescribing in primary care for urinary tract infections (UTIs) in pregnancy: an audit study. Medical Sciences. doi: 10.3390/medsci8030040.
Habak, P., Griggs Jr., R. (2023). Urinary tract infection in pregnancy. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK537047/