A client with acute pyelonephritis is prescribed Septra. Which finding best demonstrates that the client has followed the prescribed regimen?

• A. Absence of fever
• B. Bacteria are absent on urine culture
• C. Normal urine color
• D. Decreased WBC count

Answer: (B)

For acute pyelonephritis, the strongest sign that the prescribed antibiotic is being followed and is effective is that the urine culture shows no bacteria. Eradication of the pathogen from the urinary tract confirms that the regimen has worked and that the infection is resolving. Clinical improvement, like fever relief, can occur even if the culture hasn’t fully cleared yet, and a normal urine color or a decreasing white blood cell count can reflect improvement but don’t prove that the bacteria have been eliminated. So, sterile urine culture is the clear proof of successful treatment and adherence to the antibiotic plan.