Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
How To Rule Out UTI?
Question: Hi I have had signs of what i thought was ICC. It kept coming and going since mid August.
I have been changing my diet and learning about how to heal the inflammation in my bladder. I am in my late fifties and realize the drop in estrogen could exacerbate this condition. Sunday, I decided to go to urgent care
to see if perhaps it is a UTI. The initial test was negative. on Wednesday, the doctor called to say the test came back positive from the lab. Since then I have been taking cranberry pills, garlic and drinking lots of water and I feel symptom free. However, he prescribed Cipro which I am extremely hesitant to take, especially if I feel good. But I just took a home UTI test and it said the leukocyte count is positive at 125 plus and that there are no nitrites present. Should I take the antibiotic? If so, would ammoxycillin be a better choice, since it seems to be an antibiotic with less side effects. I do not want to go on unnecessary antibiotics if I can avoid them, but I am not sure if I should treat the infection despite the current lack of symptoms. Could the leukocytes just be a sign of irritation and inflammation, without necessarily being an infection? Overall, I feel great and have lots of energy. Thank you in advance.
I have been changing my diet and learning about how to heal the inflammation in my bladder. I am in my late fifties and realize the drop in estrogen could exacerbate this condition. Sunday, I decided to go to urgent care
to see if perhaps it is a UTI. The initial test was negative. on Wednesday, the doctor called to say the test came back positive from the lab. Since then I have been taking cranberry pills, garlic and drinking lots of water and I feel symptom free. However, he prescribed Cipro which I am extremely hesitant to take, especially if I feel good. But I just took a home UTI test and it said the leukocyte count is positive at 125 plus and that there are no nitrites present. Should I take the antibiotic? If so, would ammoxycillin be a better choice, since it seems to be an antibiotic with less side effects. I do not want to go on unnecessary antibiotics if I can avoid them, but I am not sure if I should treat the infection despite the current lack of symptoms. Could the leukocytes just be a sign of irritation and inflammation, without necessarily being an infection? Overall, I feel great and have lots of energy. Thank you in advance.
Brief Answer:
Here are some options:
Detailed Answer:
Hello and welcome,
First, can you define what you mean by "ICC" as this can stand for a number of things.
Regarding the bladder symptoms and leukocytes:
If your doctor sent the urine specimen to a lab and it showed an infection, I assume it was cultured. And if it was cultured, usually a test called a "sensitivity" is run to see which antibiotics that bacteria is sensitive or resistant to. Usually there are multiple antibiotics that the identified bacteria is sensitive to, so there would be choices other than Cipro. I would ask your doctor about the culture and sensitivity report, if done.
I am not a fan of Cipro and Levofloxacin because they can cause some nasty side effects. These are rare, but not rare enough, so when possible, I try to avoid prescribing anything in the fluoroquinolone family of antibiotics.
Amoxicillin usually doesn't work for UTIs, but you can ask your doctor if amoxicillin (or ampicillin - sometimes they test this and it is the same as amox.) was tested in the sensitivity test. An antibiotic that usually works is trimethoprim-sulfamethoxazole (TMP-SMX). This antibiotic does not have the weird side effects the fluoroquinolones can have, but if you are allergic to it, you can get a rash.
If the urinalysis showed elevated leukocytes, it is most commonly caused by bacterial infection, but can be caused by anything that causes inflammation to the urinary tract, with or without infection.
If what you are dealing with is an uncomplicated lower UTI (meaning the kidneys are not involved), then it is ok to try to treat this with the things you are doing rather than antibiotics. If you develop symptoms of kidney infection, then you really do need to have an antibiotic and for the illness to be followed closely. Symptoms of pyelonephritis are fever, feeling overall sick, flank pain (such as aching in the kidney area which is in the back behind your waist) and nausea.
If you get frequent UTIs, and have been postmenopausal for a few years, you might benefit considerably from vaginal or topical estrogen. This does not have the systemic effects that oral estrogen has, but increases the health and resistance of the genitourinary tissues.
So should you take an antibiotic? If no kidney symptoms, you can continue to take cranberry powder capsules and see how things go. Cranberry juice is helpful too but I advise against the Ocean Spray stuff - too much sugar if you are drinking a lot of it. Better to get cranberry juice concentrate with nothing else in it, reconstitute it with water and a little apple juice.
I hope this information helps.
Here are some options:
Detailed Answer:
Hello and welcome,
First, can you define what you mean by "ICC" as this can stand for a number of things.
Regarding the bladder symptoms and leukocytes:
If your doctor sent the urine specimen to a lab and it showed an infection, I assume it was cultured. And if it was cultured, usually a test called a "sensitivity" is run to see which antibiotics that bacteria is sensitive or resistant to. Usually there are multiple antibiotics that the identified bacteria is sensitive to, so there would be choices other than Cipro. I would ask your doctor about the culture and sensitivity report, if done.
I am not a fan of Cipro and Levofloxacin because they can cause some nasty side effects. These are rare, but not rare enough, so when possible, I try to avoid prescribing anything in the fluoroquinolone family of antibiotics.
Amoxicillin usually doesn't work for UTIs, but you can ask your doctor if amoxicillin (or ampicillin - sometimes they test this and it is the same as amox.) was tested in the sensitivity test. An antibiotic that usually works is trimethoprim-sulfamethoxazole (TMP-SMX). This antibiotic does not have the weird side effects the fluoroquinolones can have, but if you are allergic to it, you can get a rash.
If the urinalysis showed elevated leukocytes, it is most commonly caused by bacterial infection, but can be caused by anything that causes inflammation to the urinary tract, with or without infection.
If what you are dealing with is an uncomplicated lower UTI (meaning the kidneys are not involved), then it is ok to try to treat this with the things you are doing rather than antibiotics. If you develop symptoms of kidney infection, then you really do need to have an antibiotic and for the illness to be followed closely. Symptoms of pyelonephritis are fever, feeling overall sick, flank pain (such as aching in the kidney area which is in the back behind your waist) and nausea.
If you get frequent UTIs, and have been postmenopausal for a few years, you might benefit considerably from vaginal or topical estrogen. This does not have the systemic effects that oral estrogen has, but increases the health and resistance of the genitourinary tissues.
So should you take an antibiotic? If no kidney symptoms, you can continue to take cranberry powder capsules and see how things go. Cranberry juice is helpful too but I advise against the Ocean Spray stuff - too much sugar if you are drinking a lot of it. Better to get cranberry juice concentrate with nothing else in it, reconstitute it with water and a little apple juice.
I hope this information helps.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your thorough, insightful and helpful answer. Prior to contacting you, I called the doctor's office with a similar question and was told cipro is all that they prescribe for UTI's.
Your answer was so much more comprehensive. Cipro seemed too extreme for the very mild symptoms I am experiencing. I used the letters ICC for intercystitial cystitis. I have not had a bladder infection in over ten years and the last time, the symptoms were much more painful and did not come and go. That is why I thought it was ICC. It has been mostly just urgency and slight discomfort that comes and goes. I purchased ellura and d mannose online and I will see what happens.
ellura is apparently what urologists in Europe suggest for UTI's. I appreciate your conservative open approach to delaying extreme measures, and in using a potentially safer antibiotic, with less side effects.
Thank you again!
Warm regards,
xxxxxxxxxxxxxxxxxxxxx
Your answer was so much more comprehensive. Cipro seemed too extreme for the very mild symptoms I am experiencing. I used the letters ICC for intercystitial cystitis. I have not had a bladder infection in over ten years and the last time, the symptoms were much more painful and did not come and go. That is why I thought it was ICC. It has been mostly just urgency and slight discomfort that comes and goes. I purchased ellura and d mannose online and I will see what happens.
ellura is apparently what urologists in Europe suggest for UTI's. I appreciate your conservative open approach to delaying extreme measures, and in using a potentially safer antibiotic, with less side effects.
Thank you again!
Warm regards,
xxxxxxxxxxxxxxxxxxxxx
Brief Answer:
Your welcome
Detailed Answer:
The ellura and d-mannose seem reasonable to use. If you get excessive bloating and loose stools then you will want to cut back a bit on the d-mannose.
If your urinary symptoms return and are mild and intermittent as you described, that could be from estrogen deficiency. Not that you can't get a full-out painful UTI when you have estrogen deficiency, but low grade intermittent or chronic UTI symptoms are sometimes associated with estrogen deficiency. Just something to keep in mind if the problem returns.
Best regards,
Bonnie Berger-Durnbaugh, MD
Your welcome
Detailed Answer:
The ellura and d-mannose seem reasonable to use. If you get excessive bloating and loose stools then you will want to cut back a bit on the d-mannose.
If your urinary symptoms return and are mild and intermittent as you described, that could be from estrogen deficiency. Not that you can't get a full-out painful UTI when you have estrogen deficiency, but low grade intermittent or chronic UTI symptoms are sometimes associated with estrogen deficiency. Just something to keep in mind if the problem returns.
Best regards,
Bonnie Berger-Durnbaugh, MD
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
