A female patient was treated with antibiotics for chlamydia induced UTI, suddenly presents again with itching/pruritus, vaginal discharge, burning micturition. Which drug should be given?
High-Yield Explanation
Ref: Goodman & Gillman 13th ed. P 1017* The patient in the given case has chlamydia induced UTI. The agent that can be preferred for management of such condition is fluroquinolones (FQ).* Books state: "FQs are more efficacious than trimethoprim- sulfamethoxazole or oral B-Lactams". Moxifloxacin doesn't accumulate in urine and hence NOT approved for treatment of UTI.* Fluoroquinolones lack activity for Treponema pallidum but have activity in vitro against Chlamydia trachomatis and Haemophilus ducreyi.* This patient later presented with symptoms of sexually transmitted infection, for which the best option is Azithromycin, single dose is effective.* Book states: "For chlamydial urethritis/cervicitis, a 7-day course of ofloxacin or levofloxacin is an alternative to a 7-day treatment with doxycycline or a single dose of azithromycin; other available quinolones are NOT effective in these condition"