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Suggest Treatment For Acute Urinary Tract Infection In A Diabetic

Posted on Mon, 19 Jan 2015

Question: My father has ckd 5 , cld, cops & diabetic. He has suffering from acute urine tract infection from last 15 days. I have gone for urine culture report show only colistin antibiotic is sensitive. All other antibiotic reactive. Urine routine results protein +++gulcose +++ leukocyte +++. If I gone for colistin that has side effect on Kinsey . What we have to do for this. From last 3 days sugar is also up fasting 400. Randomlme 500

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
You have to give him Colistin.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your father has Severe Diabetic Nephropathy with severe UTI.

I shall be happy if you can post me report of Urine culture to make precise comments on his problems.

Though Colistin is known to have side effects as urine culture has revealed organisms being resistant to all antibiotics except Colistin you have no option but to give the drug keeping close watch on side effects .

Since he has multiple health issues he should be under constant observation of Nephrologist.

Ensure his Diabetes is under reasonable control and he does not land up in Diabetic ketoacidosis .

Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. P. T. Patil (2 hours later)

Sir now pus cell is numerous . how much side effect is of Colistin can we go for this antibiotic ar home. Urine is totally concentrated like yellowish sediments why this type of culture results that only one antibiotic is sensitive now fasting sugar come down to 240

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
It depends upon the organisms causing the infection

Detailed Answer:
Hello
Thanks for follow up

Side effects of colistin may or may not occur, but we have no option other than to take chances and hope for good results

Sensitivity of organisms depends upon their habitat and it is not mandatory that it should be sensitive to all the antibiotics.

Thanks and regards.
dr XXXXXXX

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. P. T. Patil (8 hours later)

for how much value of cretanine & urea should we wait for dialysis. I have admitted my father to hospital they have started Colistin antibiotic. today before starting antibiotic cretanine was 6.9

Answered by Dr. Dr. P. T. Patil (2 hours later)

Brief Answer:
One has to wait for a week and let the infection be under control

Detailed Answer:
Hello
Thanks for follow up.
Continue antibiotics for a week and repeat creatinine levels .If it remains high above 7 he will need dialysis .
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar