Final answer:
The best medication for a 59 year old male patient with UTI symptoms and lab results positive for E. coli in prostatic fluid is Ciprofloxacin, a fluoroquinolone antibiotic commonly used to treat bacterial infections.
Step-by-step explanation:
The 59 year old male patient with acute onset of suprapubic discomfort, dysuria, nocturia, and increased frequency, whose lab results include a normal UA, elevated PSA, and Prostatic fluid positive for E. coli, is likely suffering from a urinary tract infection (UTI). Given that the prostate gland appears normal, the elevation in PSA and presence of E. coli in prostatic fluid suggests a bacterial infection. In medical practice, bacterial cystitis is commonly treated with antibiotics such as fluoroquinolones, nitrofurantoin, cephalosporins, or a combination of trimethoprim and sulfamethoxazole.
Specifically, ciprofloxacin, a fluoroquinolone, is often prescribed for UTIs caused by E. coli and other gram-negative bacteria, which makes option d. Cipro the recommended medication for this patient. It's important to note that elderly patients are at higher risk of complications, so close monitoring and perhaps a longer duration of treatment may be indicated.