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68 yo M is evaluated for fever, perineal pain, dysuria, frequency, and intermittent straining that began yesterday. Sx began 48 hours after a prostate biopsy due to an elevated PSA. Most appropriate tx?

User Majoren
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1 Answer

2 votes

Final answer:

The most appropriate treatment for the 68-year-old man with UTI symptoms following a prostate biopsy is a course of antibiotics, with commonly prescribed options including fluoroquinolones and nitrofurantoin. Pain relief for dysuria may also be provided. A urine culture should be conducted to determine the specific bacteria responsible.

Step-by-step explanation:

The 68-year-old male patient described is showing classic symptoms following a prostate biopsy, which can include fever, perineal pain, dysuria, urinary frequency, and intermittent straining. These symptoms are typically indicative of a urinary tract infection (UTI), especially given the recent urological procedure and the patient's elevated PSA levels prior to the biopsy. Considering the patient's age and previous prostate condition potentially leading to incomplete bladder emptying, and subsequent dehydration, there is an increased risk for UTIs.

For treatment, a course of antibiotics is most appropriate. Drugs such as fluoroquinolones, nitrofurantoin, or a combination of trimethoprim and sulfamethoxazole are commonly prescribed for bacterial cystitis. Additional pain medications can be provided for relief of dysuria. It is crucial to start treatment promptly to prevent complications like sepsis or kidney infections, which are more common in elderly patients.

Given the recent medical history of a prostate biopsy and the current symptoms, it is essential for the healthcare provider to order a urine culture and sensitivity test to identify the specific causative bacteria and determine the most effective antibiotic therapy.

User Remko Popma
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