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Suggest Medication For Persistent UTI

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Posted on Mon, 7 Dec 2015
Question: I had a uti in XXXXXXX Keflex didn't eradicate it. Took macrobid and urine was clear on dipstick for a couple of months even though minor urethra and vaginal irritation continued. Started using vaginal estriol cream (I am 64 year old, post menopausal). Symptoms increased a bit, still not horrible, in September. Had white cells on dip. Took macrobid 2 weeks. Again clear urine dip and symptoms reduced but not totally gone. Now it's back again. Cultured it and ecoli is present. Symptoms still relatively minor... Urethra and vaginal irritation is main symptom and that is off and on. This time the Dr put me on one week macrobid with change to ampicillin afterthat... Low dose, 250 mg 3 times a day dfor 6 weeks. I hate to take antibiotics and just wondering of that sounds Okay. I don't understand where this is coming from and I worry alot and am pretty scared. I'm not sexually active either. I use cranberry tabs and d-mannose and other anti inflammatory supplements and drink lots of water. Sometimes I don't feel anything. My doctor thinks there may be an access in the bladder, which is why he is treating long term. But I don't see anything on the internet to even suggest that possibility. Also, my sister is deathly allergic to penicillin so I have always refused it. Dr says that is not a valid reason and it is the safest. I'm also worrying about cancer. But Dr said my urine showed normal amts of epithelial cells and rbc so he says that shouldn't be a concern. Please help... I'm really nervous.... Can't sleep
doctor
Answered by Dr. Rakesh Madhyastha (47 minutes later)
Brief Answer:
Urinary tract infection

Detailed Answer:
Hello

Thanks for the query

Recurrent urinary tract infection calls for the following tests
1. Ultra sound of the abdomen and pelvis to rule out anatomic abnormalities or renal stones
2. Testing for diabetes
3. History of personal hygiene and preferences

Urethral and vaginal irriatation is more common in post menopausal women due to change in the ph of the vagina and loss of secretion. It might not always mean urinary tract infection, please continue to apply estriol cream.

Here is how you should go about it

1. Send for a urine routine and culture again. Make sure the sample you give is after cleaning the eternal urethral meatus
2. Drink plenty of water, about 2-3 litres per day to prevent UTI
3. After passing stools, always make sure you clean the anus away from the vagina and not towards it

I hope I was of help, if you have any further queries please get back to me

Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Rakesh Madhyastha (14 minutes later)
You didn't really answer my question about the course my Dr prescribed or the penicillin etc or bladder abscess. I do all those things you said. I've never had diabetes and there's zero sugar in my urine now. I don't have ins so shouldn't I do other things before ultrasound? I don't have any pain like there's stones. I had an ultrasound Yeats ago when I was having utis and I was structurally normal then. Don't know of that changes
doctor
Answered by Dr. Rakesh Madhyastha (7 hours later)
Brief Answer:
Cannot be an abscess

Detailed Answer:
Hello

Thanks for getting back, here are my thoughts in regards to the issues you have raised

1. Bladder abscess would have been picked up through the ultra sound and besides an abscess usually presents with severe fever with chills and rigor. Abscess according to me is ruled out. Besides bladder abscesses are extremely rare
2. I don't think it's necessary to avoid penicillin group of drugs just because your sibling is allergic. You could opt for a test dose of a penicillin injection just to see if you are allergic nonetheless
3. like I have explained post menopausal women are more prone for Uti due to the change in the ph, recurrent uti calls for a prophylactic antibiotic like nitrofurantoin 100 mg in the evening. I strongly recommend that you are on prophylaxis


Please get back to me if you have any further doubts. I will be happy to clarify them

Regards
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. Yogesh D
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Answered by
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Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4364 Questions

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Suggest Medication For Persistent UTI

Brief Answer: Urinary tract infection Detailed Answer: Hello Thanks for the query Recurrent urinary tract infection calls for the following tests 1. Ultra sound of the abdomen and pelvis to rule out anatomic abnormalities or renal stones 2. Testing for diabetes 3. History of personal hygiene and preferences Urethral and vaginal irriatation is more common in post menopausal women due to change in the ph of the vagina and loss of secretion. It might not always mean urinary tract infection, please continue to apply estriol cream. Here is how you should go about it 1. Send for a urine routine and culture again. Make sure the sample you give is after cleaning the eternal urethral meatus 2. Drink plenty of water, about 2-3 litres per day to prevent UTI 3. After passing stools, always make sure you clean the anus away from the vagina and not towards it I hope I was of help, if you have any further queries please get back to me Regards