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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Take Bactrim For UTI Without Any Prior Testing?

I had a uti a wk. ago for 4 days. When I got home took a 24 dose of penicillin. Uti was gone in that 24 hr. Time frame. 3 days later at 3am woke up with fever 103 & for the last 4 nights I wake up with a fever 103-104. Went to dr. Did blood tests, urine & urine culture. They prescribed Bactrim. Didn t find anything in tests. Still don t have an appetite, but no fever. I did have hepatitis c a while ago but under treatment was undetected now. Concerned because of cirrhosis of the liver. Should I be taking this drug?
Fri, 29 Jan 2021
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General & Family Physician 's  Response
Hi,

UTI is often diagnosed based on symptoms alone, and many women with a previous history of UTI can accurately know by themselves if they are having an episode of UTI. It is not uncommon to give Bactrim for UTI treatment without doing any testing. Penicillin is not the first choice of antibiotic for the treatment of UTI. It is only used in rare cases in the treatment of UTI, such as in pregnancy-associated with asymptomatic bacteriuria (Amoxicillin).

I think that is the reason your doctor gave you Bactrim because he thought that Penicillin you took for your UTI did not cure it. Now regarding the side effects, Bactrim can cause liver damage, and certainly, if you have existing cirrhosis, it would be riskier. However, the duration of treatment for UTI is concise. So it depends on the clinical judgment of your doctor.

If I were your doctor, I would have given you Ciprofloxacin, which is, as per clinical studies, safer to use in cirrhosis patients and more effective in treating Complicated UTI, which I suspect you have. Another thing to keep in mind is that untreated UTI can lead to more serious complications like Pyelonephritis, present with high-grade fever-like yours, and flank pain. If that's the case, you need to contact your doctor immediately or go to ER.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Saralkumar R. Desai, General & Family Physician
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Is It Safe To Take Bactrim For UTI Without Any Prior Testing?

Hi, UTI is often diagnosed based on symptoms alone, and many women with a previous history of UTI can accurately know by themselves if they are having an episode of UTI. It is not uncommon to give Bactrim for UTI treatment without doing any testing. Penicillin is not the first choice of antibiotic for the treatment of UTI. It is only used in rare cases in the treatment of UTI, such as in pregnancy-associated with asymptomatic bacteriuria (Amoxicillin). I think that is the reason your doctor gave you Bactrim because he thought that Penicillin you took for your UTI did not cure it. Now regarding the side effects, Bactrim can cause liver damage, and certainly, if you have existing cirrhosis, it would be riskier. However, the duration of treatment for UTI is concise. So it depends on the clinical judgment of your doctor. If I were your doctor, I would have given you Ciprofloxacin, which is, as per clinical studies, safer to use in cirrhosis patients and more effective in treating Complicated UTI, which I suspect you have. Another thing to keep in mind is that untreated UTI can lead to more serious complications like Pyelonephritis, present with high-grade fever-like yours, and flank pain. If that s the case, you need to contact your doctor immediately or go to ER. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Saralkumar R. Desai, General & Family Physician