Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Hello Doctor, My Father Is A Doctor General Physician. One
Question: Hello Doctor, my father is a doctor general physician. one of his friend is also a doctor he discussed a medical issue of his relation. I have given the the details shared by him below. please advice us on this Hi friends can anyone suggest a treatment plan for recurrent UTI in a 70 yr old man . Culture showed E.Coli sensitive to Notrofurantoin , Doxycycline , Augmentin. and other parental drugs . Resistant to Laevo floc. Was on Nitrofurantoin bd for 10 days and then continued with 1 of but after 3 days all the symptoms came back with a bang â severe strangury . Nitrofurantoin is bacteriostatic - is the choice of antibiotic incorrect . Pt is diabetic but with good control of sugars. Thanks.
Brief Answer:
Need details
Detailed Answer:
Hello Samarthan,
As per your query, your relative has rec.UTI with Diabetes.
He/she should get the following tests done for proper advice to be given.
1.latest urine culture report.(repeat if not done in the last two weeks.)
2. last s.creatinine, FBS and HbA1c report.
3.Uroflowmetry test.
4.Ultrasound scan-KUB with residual urine estimation.
5.What were the other symptoms that bothered him/her the most.
After going through all the reports, i shall give you expert advise.
Wishing your relative well.
Dr.Matthew J.Mangat.
Need details
Detailed Answer:
Hello Samarthan,
As per your query, your relative has rec.UTI with Diabetes.
He/she should get the following tests done for proper advice to be given.
1.latest urine culture report.(repeat if not done in the last two weeks.)
2. last s.creatinine, FBS and HbA1c report.
3.Uroflowmetry test.
4.Ultrasound scan-KUB with residual urine estimation.
5.What were the other symptoms that bothered him/her the most.
After going through all the reports, i shall give you expert advise.
Wishing your relative well.
Dr.Matthew J.Mangat.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear doctor, I have shared further information about the patient and also have attached medical reports of the patient. kindly go through and pls advice us on this. Uroflowmetry has been done several times in the past and it has always been normal . Hb1Ac is 6.7 and his fasting sugar is 120 and PP is 140 . His sugars are well under control . His last episode was in 2016 and he took long term antibiotics and till date he was free . It is 3 days since the Nitrogurantoin dose was reduced to 1 per day since he already took the same bd for 10 days. Last night he got up with dysuria and strangury . No fever or chills . He then took Urispas , Tremadol and another antibiotic Doxycycline. After 3 hrs the symptom came down and then he slept. The symptoms have come down and he has now gone to the hospital for US and if possible CT also . 4 days back the doctor had examined him and said that the prostate is normal . He had never been catheterised . Urine flow is good . He is now on Docy and Nitro , and sporlac DS , . Thanks.
Brief Answer:
follow-up with 3 attachments.
Detailed Answer:
Hello Samarthan,
The US-KUB scan of Dr.Sesikeran shows significant residual urine( 110ml) .
The last s.creatinine report isn't sent.
The last or repeat urine culture also isn't enclosed.
He needs to do a PSA also.
Both antibiotics aren't advised to be taken by Dr.Sesikeran.
It's better that he continue with Tab.Nitrofurantoin at bedtime.
After seeing the reports, I can give expert advice as a Urologist.
Dr.Matthew J.Mangat
follow-up with 3 attachments.
Detailed Answer:
Hello Samarthan,
The US-KUB scan of Dr.Sesikeran shows significant residual urine( 110ml) .
The last s.creatinine report isn't sent.
The last or repeat urine culture also isn't enclosed.
He needs to do a PSA also.
Both antibiotics aren't advised to be taken by Dr.Sesikeran.
It's better that he continue with Tab.Nitrofurantoin at bedtime.
After seeing the reports, I can give expert advice as a Urologist.
Dr.Matthew J.Mangat
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear doctor, I have given further information u have asked for. His creatinine level done last week is 0.97. ( normal range o.6 to 1.1) BUN â- 8.19 mg/FL (Normal range 7 to 25 ) Culture was done at the onset of the problem and since he is on antibiotics continuously a repeat culture was not done. The second antibiotic was started when he had an acute relapse . Strangury was so severe that he couldnât sleep . Only after taking Tremadol , Urispas and citralka he could dose off. Only after this acute episode he started the second antibiotic .The symptoms have subsided. thanks.
Brief Answer:
some more details given.
Detailed Answer:
Hello Samarthan,
Now only his PSA report is remaining.
The U/S-KUB doesn't mention the size or volume of prostate.
Anyway, one thing is clear from available reports.
Dr.Shasi XXXXXXX should've got a per rectal examination by a
qualified Urologist, to assess his prostate gland.
He must've his PSA done, being 67 years of age.
Most likely it's the prostate gland enlargement with or
without prostatitis, that's the cause for significant residual urine.
It should be also the cause for the UTI.
Till he has the clinical examination done, contiue with
Tab.Nitrofurantoin and Urispas at bedtime.
He should be taking an alfa-blocker, dose of which will be
decided after the per-rectal examination.
Phenazopyridine as syrup is very useful to relieve dysuria.
He should remain well hydrated at all times and repeat the
urine culture, two to three days after stopping antibiotics.
You're to welcome to contact me anytime.
Dr.Matthew J. Mangat.
some more details given.
Detailed Answer:
Hello Samarthan,
Now only his PSA report is remaining.
The U/S-KUB doesn't mention the size or volume of prostate.
Anyway, one thing is clear from available reports.
Dr.Shasi XXXXXXX should've got a per rectal examination by a
qualified Urologist, to assess his prostate gland.
He must've his PSA done, being 67 years of age.
Most likely it's the prostate gland enlargement with or
without prostatitis, that's the cause for significant residual urine.
It should be also the cause for the UTI.
Till he has the clinical examination done, contiue with
Tab.Nitrofurantoin and Urispas at bedtime.
He should be taking an alfa-blocker, dose of which will be
decided after the per-rectal examination.
Phenazopyridine as syrup is very useful to relieve dysuria.
He should remain well hydrated at all times and repeat the
urine culture, two to three days after stopping antibiotics.
You're to welcome to contact me anytime.
Dr.Matthew J. Mangat.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
