What Causes Recurrent UTI?

Posted on Mon, 14 Jul 2014

Question: Hi,

2 Months back i got UTI infection due to stone problem, my doctor put me on antibiotic norflox 400mg. After taking 5 days he ask me to continue the same for 2 week due to 10000 col growth. Unfortunately i missed a dose and forgot to take uriliser syrup also.

Suddenly I got high fever 103, I got hospitalized they put me on heavy antibiotics and got my CT scan as per doctor a stone stayed in left ureter for long and while passing out it infected the kidney as well and they called it pyelonephritis. They give me Tazomac inj with moxif for 10 days.

Then for 4 days augmentin duo
and then Marifur MR - BD for 15 days
and then Marifur MR one tab daily for 15 days but i have taken this for 7 days only

I got Urine routine and culture again and it was normal so i have skipped martifur mr for last one week.

Now I have 2 stone in my right kidney of 3 mm in size. After 20 days i got again infection in culture report and this time it high in resistance of many antibiotics and ESBL is positive I am feeling urine burning sensation but there is no fever this time and i am feeling well. But my Physician has asked to get hospitalized again and this time he saying we will give you meropenem for 3 time a day and it will go for 15 days.

I am confused should i go for such high antibiotic or not.

Saturday i visited a urologist he told me there is no need of such high antibiotic till you not got any fever and he gave me

Nitrofurantoin 100 mg(its sendstive in my culture report) - BD for 14 days and
Cranpac -d nd for 14 days and visit him after 7 days with urine culture and routine and USG KUB.

could you suggest me on above which doc is giving me right treatment.

Thanks

Answered by Dr. Deepak Kishore Kaltari (14 minutes later)

Brief Answer:
Iv antibiotics usually when there is fever

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Namasthe XXXXXX

Intravenous antibiotic are usually indicated for following indication
1. Presence of high grade fever documented to be due to urinary tract infection
2. Urinary tract infection involving the upper tract which is Kidney and ureter.

Presence of foreign body like a stone could be cause for recurring infection.
Had you been my patient I would have managed you by following

1. Investigation: Complete blood count and Ultrasound of abdomen.

If the white blood cell count are normal and ultrasound abdomen does not reveal any infection of kidney then oral antibiotics as per culture report would be sufficient.

I would also put you on low dose chemo prophylaxis ( single dose antibiotic everyday like Cefixime or Nitrofurantoin) after 10 days course of therapeutic dose of antibiotics ( full recommended dose).
Also urinary analgesic like Phenazopyridium will be helpful in reliving burning sensation. Consume 2 to 3 liter of water everyday.

Do keep me updated about your progress.
Wishing you great health.
Take care
Best Regards
Dr Deepak Kishore
MBBS, MS, MCh

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

Follow up: Dr. Deepak Kishore Kaltari (30 minutes later)

So

I should follow treatment of my urologist as he put me on Nitrofurantoin 100mg BD and asked for Urine routine and culture with USG of KUB after 7 days.

Its not required to go on such high IV antibiotic meropenem as there is no fever.

Answered by Dr. Deepak Kishore Kaltari (2 minutes later)

Brief Answer:
Follow advise of your Urologist

Detailed Answer:
Namasthe

Definitely, follow the advise of your Urologist.

Wishing you great health.

Take care
Best regards
Dr Deepak

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