Acute Caremiddle twist
An 88-year-old woman in residential aged care has had an indwelling urethral catheter for eight months for a neurogenic bladder, and it will be needed indefinitely. Over two days she has become more confused than usual and has new suprapubic discomfort. Her temperature is 37.9°C, she has had no rigors, she is eating and drinking normally and her renal function is normal. A catheter specimen of urine grows Escherichia coli sensitive to trimethoprim, amoxicillin and gentamicin. Which one of the following management plans is most appropriate?