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What Causes Recurring Bladder Infections?

Posted on Wed, 25 Jun 2014

Question: My concern is reoccurring bladder infections. About every six months. I have been put on Vagifem 2xweekly, daily probiotics and cranberry capsules by my urologist. The lab reports Kiel

Answered by Dr. G.Srinivasan (4 hours later)

Brief Answer:
Correct approach.

Detailed Answer:
Welcome to the forum.
Repeated infection are not uncommon in women especially after the menopause.
The essence of treatment is to treat the present infection and to prevent recurrence.

To prevent recurrence - A cause/ reason for infection - needs to be looked for by doing an ultrasound scan of the urinary tract to look for any obvious cause like stones or obstruction.
Uroflowmetry test is also advisable to look for obstruction to the urine passage.

If a cause is found in any of the above tests, it needs to be addressed.

If no cause if found, then the treatment as already prescribed by your doctor is the correct approach, mainly long term low dose antibiotic chemo-prophylaxis.

Hope i am clear.
Kindly write back for doubts if any,
Sincerely,

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. G.Srinivasan (19 hours later)

Thank you Dr XXXXXXX -
I am going to bring up these two tests with my Dr this week.
My lab results came back today from the urine test 2 days ago -
Colour yellow, cloudy and all the rest normal except for Hemaglobin +3, Leucocytes +3 - Culture results -- Escherichia Coli >100m cfu/L.

How long would a long term low dose of a/b's last? (in terms of weeks, months or a year perhaps.)

Regards, XXXXXXX

Answered by Dr. G.Srinivasan (4 hours later)

Brief Answer:
one to six months.

Detailed Answer:
Welcome back Ms. XXXXXXX
Urine results are suggestive of infection.
E. coli more than 100 cfu/ml usually does NOT need treatment, unless you are SYMPTOMATIC.

Long term low dose chemo-prophylaxis usually ranges from one to six months in half to quarter dose.

Hope i am clear.

wish you good health,

Sincerely,

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

Follow up: Dr. G.Srinivasan (31 minutes later)

Dear Dr, thank you, and yes you are very clear. I sincerely appreciate your prompt reply.
As the weekend approaches and my Dr is only in tomorrow morning- I am quite sure that I am having an allergic reaction to the Sulfa trim. I have taken it for 3 yrs and I believe my time with Sulfatrim may be up. The reason I say this is that I had similar reaction to Nitrofurdanton so I know the symptoms. - flush face, inappetance, feeling just 'blah'. lethargic, blurry vision. There is a list of drugs that I am supposedly sensitive too. In the unlikely event I actually get to see my doctor I will go to a walk in clinic and hopefully receive an alternate a/b. Do you think this is wise?
Thanks again, XXXXXXX

Answered by Dr. G.Srinivasan (23 hours later)

Brief Answer:
Get treated if you are symptomatic.

Detailed Answer:
Welcome back Ms. XXXXXXX
Sorry for the delayed reply this time.
Since both the commonly used and preferred antibiotics for chemo- prophylaxis : like sulfatrim and nitrofurantoin are NOT suitable to you, we need to think of alternate ones.
In fact any antibiotic like ciproflox, Norflox can be used at half or quarter the dose ONCE daily in your situation.

Hope i am clear,
Sincerely,

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

Follow up: Dr. G.Srinivasan (46 hours later)

Thank you Dr. I saw my family doctor on Friday and she confirmed that ai did have a bladder Ultra sound a few years ago and it was clear. So considering all factors I am now on Fosfomycin 3 gr. -- this is totally new for me and my Dr feels confident this will work without a reaction. My pharmacist likes this drug also.
So Dr Scrinivasan, thanks for all your advice, it was most helpful and confirms that what I am doing is agreed by another urologist.
If need be I will get back to you in the future but for now, all is good.
Much appreciation, XXXXXXX

Answered by Dr. G.Srinivasan (2 hours later)

Brief Answer:
welcome.

Detailed Answer:
Welcome back Ms. XXXXXXX
Wishing you good health,
Regards

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