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Is There Any Way To Majorly Reduce The Onset Of Chills?
Question: I am a 72 year old male who suffers from frequent E Coli infections in bladder due to incomplete voiding. Have developed a resistance to virtually all commonly prescribed antibiotics for UTI's. Reaction to Macrobid has been severe chills both times I have tried it, but this is supposed to be the most effective treatment. Is there any way to majorly reduce the onset of chills?
Brief Answer:
Please provide few more details
Detailed Answer:
Hello
Thanks for query .
Based on the facts that you have posted you seem to have been getting repeated episodes of UTI.
Considering your age of 72 years this could be mostly secondary to Enlarged Prostate which is very common at this age .
I shall be happy if you can post me more details to help me in making precise comments and suggestions.
1) Have you consulted qualified Urologist ?
2) Are you Diabetic?
3) Have done Ultrasound Scanning of abdomen to assess size of prostate and Post Void Residue of urine (PVR)?4) Have you done Uroflowmetry study if so post the report ?
5) Have you done relevant blood tests for PSA and to assess Renal Function ?
5) Was Urine culture done ant time ?
It should always be our primary aim to establish basic pathology and cause for your UTI and treat the same to avoid getting repeated episodes of UTI rather than changing antibiotics .
Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Uroflowmetry.
.Further treatment will depend upon result of these tests and final diagnosis.
As regards reaction of chills which you assume to be due to Macrobid I would state that getting chills is the predominant symptom of UTI itself ,so it is unlikely to be due to Macrobid .
Expecting your feedback .Please do write if you have more questions I shall be happy to address your concern.
Thanks and Regards.
Dr Patil.
Please provide few more details
Detailed Answer:
Hello
Thanks for query .
Based on the facts that you have posted you seem to have been getting repeated episodes of UTI.
Considering your age of 72 years this could be mostly secondary to Enlarged Prostate which is very common at this age .
I shall be happy if you can post me more details to help me in making precise comments and suggestions.
1) Have you consulted qualified Urologist ?
2) Are you Diabetic?
3) Have done Ultrasound Scanning of abdomen to assess size of prostate and Post Void Residue of urine (PVR)?4) Have you done Uroflowmetry study if so post the report ?
5) Have you done relevant blood tests for PSA and to assess Renal Function ?
5) Was Urine culture done ant time ?
It should always be our primary aim to establish basic pathology and cause for your UTI and treat the same to avoid getting repeated episodes of UTI rather than changing antibiotics .
Consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Serum PSA.
4) Uroflowmetry.
.Further treatment will depend upon result of these tests and final diagnosis.
As regards reaction of chills which you assume to be due to Macrobid I would state that getting chills is the predominant symptom of UTI itself ,so it is unlikely to be due to Macrobid .
Expecting your feedback .Please do write if you have more questions I shall be happy to address your concern.
Thanks and Regards.
Dr Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
To answer your questions:
1. I have been under treatment by the head of Urology at Weil-Cornell and his successors since 1999.
2. Prostate was removed in 2004 using HiFU in Munich Germany by the inventor of the technique. PSA is negligible.
3. Post void residue has ranged from 650-1000+ ml.
4. Current treatment includes: Bethanechol - 50mg-3x/day + Methenam HIP-1gm-2x/day + Fosfomycin Tromethamine -3GM - 4 doses over 12 days periodically.
5. Latest urine culture shows >100,000 CFU/mL Escherichia coli
6. Current treatment includes insertion of catheter for 12-18 days at a time every 45-60 days to ensure full drainage.
So you see the standard diagnosis & treatments have all been tried. The only medicine not tried so far is Macrobid because of the adverse effects suffered on the 2 occasions it was tested. Chills is a widely reported side-effect of Macrobid. The question is what can one take to lessen the intensity of those chills. Current urologist does not know of anything. Hence this reach-out.
1. I have been under treatment by the head of Urology at Weil-Cornell and his successors since 1999.
2. Prostate was removed in 2004 using HiFU in Munich Germany by the inventor of the technique. PSA is negligible.
3. Post void residue has ranged from 650-1000+ ml.
4. Current treatment includes: Bethanechol - 50mg-3x/day + Methenam HIP-1gm-2x/day + Fosfomycin Tromethamine -3GM - 4 doses over 12 days periodically.
5. Latest urine culture shows >100,000 CFU/mL Escherichia coli
6. Current treatment includes insertion of catheter for 12-18 days at a time every 45-60 days to ensure full drainage.
So you see the standard diagnosis & treatments have all been tried. The only medicine not tried so far is Macrobid because of the adverse effects suffered on the 2 occasions it was tested. Chills is a widely reported side-effect of Macrobid. The question is what can one take to lessen the intensity of those chills. Current urologist does not know of anything. Hence this reach-out.
Brief Answer:
Need to reevaluate again
Detailed Answer:
Hello
Thanks for follow up and feedback.
The cause of repeated UTI in your case is significant post void residual urine (650-1000ml) and under detrusal activity needing Bethanechol to be given .
I would suggest to get Urodynamic study to evaluate and confirm power of bladder muscle .
Since bacteria always change their sensitivity pattern you need to repeat urine culture every time you have UTI and take appropriate antibiotic as per culture report .
Thanks and Regards
Dr .Patil
Need to reevaluate again
Detailed Answer:
Hello
Thanks for follow up and feedback.
The cause of repeated UTI in your case is significant post void residual urine (650-1000ml) and under detrusal activity needing Bethanechol to be given .
I would suggest to get Urodynamic study to evaluate and confirm power of bladder muscle .
Since bacteria always change their sensitivity pattern you need to repeat urine culture every time you have UTI and take appropriate antibiotic as per culture report .
Thanks and Regards
Dr .Patil
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. Chakravarthy Mazumdar
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