A male patient is complaining of frothy discharge and painful urination. After negative NAAT testing, you will most likely prescribe (NCLEX/HESI/TEAS)
a. penicillin.
b. tetracycline.
c. a cephalosporin.
d. metronidazole.

Verified step by step guidance

1. Identify the symptoms presented by the patient: frothy discharge and painful urination.
2. Consider the negative NAAT (Nucleic Acid Amplification Test) results, which rule out certain bacterial infections like gonorrhea and chlamydia.
3. Recognize that the symptoms are indicative of a protozoal infection, specifically Trichomonas vaginalis, which is not detected by NAAT.
4. Recall that metronidazole is the drug of choice for treating Trichomonas infections, as it is effective against anaerobic bacteria and certain protozoa.
5. Conclude that based on the symptoms and negative NAAT results, metronidazole is the most appropriate prescription.

Key Concepts

Frothy Discharge and Painful Urination

Frothy discharge and painful urination are symptoms often associated with certain sexually transmitted infections (STIs), particularly trichomoniasis. This condition is caused by the protozoan parasite Trichomonas vaginalis, which can lead to inflammation and discomfort in the urinary tract. Understanding these symptoms is crucial for diagnosing the underlying infection and determining the appropriate treatment.

NAAT Testing

Nucleic Acid Amplification Tests (NAAT) are highly sensitive and specific diagnostic tests used to detect the genetic material of pathogens, including bacteria and viruses. A negative NAAT result suggests that common STIs, such as chlamydia and gonorrhea, are unlikely. This information is vital for guiding treatment decisions, as it helps narrow down the potential causes of the patient's symptoms.

Metronidazole as Treatment

Metronidazole is an antibiotic commonly used to treat infections caused by anaerobic bacteria and certain protozoa, including Trichomonas vaginalis. Given the patient's symptoms and the negative NAAT results, metronidazole is the most appropriate choice for treating trichomoniasis. Understanding the mechanism of action and spectrum of activity of metronidazole is essential for effective treatment in cases of suspected parasitic infections.