Clinical Decision-Making (CDM) Cases Part I Practice Test

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If a patient has recurrent UTIs within 3 months, which test is indicated to guide therapy?
Correct Answer:
Urine culture with sensitivities
Explanation:
The main concept is using microbiologic testing to tailor therapy for recurrent urinary tract infections. A urine culture with sensitivities identifies the specific organism causing the infection and shows which antibiotics it is susceptible to. This lets you select the most effective, targeted antibiotic and avoid unnecessary broad-spectrum treatment, which is especially important when infections recur and resistance patterns may vary. Imaging studies like pelvic ultrasound, CT pelvis, or renal ultrasound don’t determine which antibiotic will work; they’re used if there’s suspicion of structural problems, obstruction, stones, or complicated infection, or if symptoms don’t resolve with therapy. So, a urine culture with sensitivities is the best test to guide therapy in recurrent UTIs within three months.

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