Suggest Treatment For Severe Acidity And Persistent Left Flank Pain

Posted on Mon, 30 Jan 2017

Question: Dear sir / madam
i undergone through a retrograde endopyelotomy 2 months back. DJ stents were removed 23rd December 2016 and I was feeling perfectly alright for next three days. suddenly got fever and left flank pain. took paracetamol but fever continued to rise every evening.
did urine RE and urine culture, report attached.
Doctor prescribed me monural ( fosfomycine) 3g XXXXXXX on alternate days. took three sachets but reported severe diarrhea with it.
Doctor advised to change medicine and prescribed nitrofurantoin 100mg twice a day for 7 - 14 days. Please note that I was a febrile with one XXXXXXX of monural. flank pain severity reduced to 10%. I was scared to take nitrofurantoin due its many side effect. I have started taking it on doctors advice.
I have following querries
1- Do i need to take it for 14 days though I have taken fosfomycin 3 sachets on alternate days ?
2- Can I continue taking esomeprazole magesium and glucophage while taking nitrofurantoin. I regularly take PPI and without it GERD symptoms worsens ?
3- Is there any other medicine that I can take to clear the reported bacteria. I am even willing to get injectable shots?

attached culture report was sampled before starting antibacterial drug.

I am feeling severe acidity, dyspepsia, belching without PPI.

Please advise any drug that can effectively replace nitrofurantoin???

Answered by Dr. Rudina Balliu (4 hours later)

Brief Answer:
Follow the advises

Detailed Answer:
Hi Dear ! Thank you for posting your question to HCM.
I read your concern carefully and I can understand. Yes I've reviewed the attached report.

I did some research before guiding you and there are no interactions found between Nitrofurantoin and Esomeprazole or Glucophage (Metformin) .

You can use them together.

You should take Nitrofurantoin after you eat on a full stomach to prevent dyspepsia and you can start again Esomeprazolto protect your stomach and for GERD.

You can take Nitrofurantoin for 7 to XXXXXXX 10 days in this dosage .

You can take after, a prophylactic dosage 50 mg in the evening /once a day for 1 month to prevent cystitis.

** Fosfomycin you should not take more then 2 XXXXXXX (not 3) because of possible side effect .

As I can understand with the symptoms you prescribed, it could be more a kidney infection than a bladder infection and in that case Nitrofurantoin or fosfomycine It's not sure that will fight it properly, cause that are used for Cystitis ( bladder infection ) not pyelonephritis .

If I were your treating doctor in a case like yours, I would start Ceftriaxone , Clindamycin , penicillin ( before using rule out any allergic reaction) as drugs that can effectively replace Nitrofurantoin and a better choice .

Please discuss with your treating doctor for this options .

If you symptoms don't go away within 48 hours after you use Nitrofurantoin or you have any allergic reaction to this drug you should go immediately to your local doctor . (If a drug is effective You should feel better within 24- 48 hours after you started otherwise the antibiotic does not work.
Drink plenty of water .

Hope this is helpful .
If you have any further questions I will be happy to help.
Take Care !
Dr Balliu .

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Above answer was peer-reviewed by : Dr. Arnab Banerjee