system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 27-year-old woman comes to the physician because of a 2-day history of severe burning pain with urination, and urinary frequency. She has no history of serious illness. The patient and her husband are currently trying to conceive a child. Her only medication is a prenatal multivitamin. Her temperature is 36.5°C (97.7°F), pulse is 75/min, and blood pressure is 125/78 mm Hg. Examination shows mild tenderness to palpation over the suprapubic region. There is no costovertebral angle tenderness. The remainder of the examination shows no abnormalities. Laboratory studies show:
Hemoglobin 14.8 g/dL
Leukocyte count 8,200/mm3
Platelet count 230,000/mm3
Urine
pH 7
WBC 52/hpf
RBC 17/hpf
Protein negative
Nitrites positive
Leukocyte esterase positive
A urine pregnancy test is negative. Which of the following is the most appropriate next step in management?"
assistant
Oral fosfomycin