QuestionSBA
QuestionChoice
This should be avoided as the patient is on methotrexate. Combining trimethoprim and methotrexate increases the risk of haematological side effects (sometimes fatal).
10035619
c
Trimethoprim for 3 days
QuestionChoice
In men, the recommended treatment is 7 days of oral nitrofurantoin. In non-pregnant women, the duration is a 3-day course.
10035618
b
Nitrofurantoin for 3 days
QuestionChoice
This is not needed at present with no concerning features. This can safely be managed in the community.
10035621
e
Admit to hospital
QuestionChoice
This should be avoided as the patient is on methotrexate. Combining trimethoprim and methotrexate increases the risk of haematological side effects (sometimes fatal).
10035620
d
Trimethoprim for 7 days
QuestionChoice
This is correct. The patient is presenting with signs and symptoms of urinary tract infection. In men, the recommended treatment is 7 days of oral nitrofurantoin, trimethoprim or amoxicillin.
10035617
a
Nitrofurantoin for 7 days
Concept
Chapter
2693
6147
Urinary tract infection
Topic
314
Primary care
19527
Urinary tract infections in men typically require a 7-day course of antibiotics, such as nitrofurantoin, trimethoprim, or amoxicillin.
A 47-year-old gentleman attends the GP with burning pain on urination and an increased frequency of urination for the last two days. Urine dip is strongly positive for leucocytes and nitrites. He has rheumatoid arthritis and takes methotrexate.

What is the most appropriate course of action?
a