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Query about infection because of the penile ring - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Penis Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1357 Questions
User :   I have gotten chronic bladder infections, probably associated with sex because they seem to follow periods of increased, or now almost any, sexual intercourse. My UTI's have have previous to the current one always been ecoli, but for the first time I'm in South and a follow-up urine culture and sensitivity analysis indicate that I now have staphylococcus epidermidis (español, so epedermis in English?), celulas planas = 1 (+), leucocitos (XC) 6-8, hematies (XC) 10-15, bacterias 3 (+), calling the result positive. Observaciones = (SISTEMA VITEK 2). No reference ranges are indicated. This current infection coincides with my new partner having a ring piercing on his penis. (1) Is the likely cause given the fact that it's now a staph infection related to his p-ring? Because I am allergic to several antibiotics and now ecoli has started showing resistivity to cipro, continuing UTI's are of heightened import. I've been prescribed cipro post-coital and macrofurantoin (sp?) post-coital with differing opinions about which is the better course. With the ecoli infections now resistant to cipro as well as most other antibiotics, Macrobid is the final antibiotic that my ecoli is no longer resistant to that doesn't have to be administered by IV. My urologist (because I have unexplained microhematuria) prescribed post-coital cipro as a preventive measure, which indeed seemed to work successfully for an extended period of time (although my last episode of ecoli was resistant to ecoli), but my internist preferred macrodantina (español, I'm in South America) post-coital, so could you throw in a third opinion on that, especially now that I've shown ecoli resistivity at least once, possibly twice to cipro, or (3) Should I instead try an extended period of a daily dose of macrodandoin (would that be macrodantina?) for at least one month up to 6 mos., which I have read can
User :   be effective in stopping chronic infections? I've read that macrodantoin (sp. in English? vs. Macrobid, a slightly different formulation) tends not to cause the problem of resistivity that happens with other antibiotics, but if indeed resistivity to Macrobid occurs, I'm in a real bind given the fact that at least for ecoli, which has previously always been the culprit, Macrobid is the only non-IV antibiotic that isn't resistant to the lastest round of ecoli. And (4) last, but not least, since these lab results were from a urine culture, I'm assuming that I should go to a urologist here. Do you agree? Sorry this is so long (!), pero sus opiniónes, por favor. And for the record, neither the urologist nor a nephrologist found anything accounting for the persistent hematuria. For that and because I take Lipitor, I have blood testing every 6 mos. And if age is relevant, I'm an otherwise very fit 61. My Spanish is pretty good, but how well I'll do depends on the accent, etc., of the doctor I see.
Doctor :   hi
User :   hi
Doctor :   let me read ur query
User :   ok
Doctor :   hi it seems that your husbands penile ring is the cause of ur recurrent infections and uti
Doctor :   not u need to take long term treatment with the best antibiotic that the bacteria is sensitive , and in this case it is macrobid
User :   except that i hadn't had sex or a partner for over a year back when I had almost nonstop infections, and that partner didn't have a ring. So u are saying that the fact that this time it's strep is due to the ring?
Doctor :   **Now
Doctor :   yes , the staph is due to the ring
Doctor :   you need a course of antibiotics for at least2 - 4 weeks to treat the infection
User :   Ok, so obviously I can solve that by saying no to the ring. But in general, minus the ring, should I continue with which cipro or macro post-coital, or should I try a long daily preventive dose irrespective of when/how often I have sex?
User :   but that's this specific infection.... what about long-term idea of longer daily for 1-6 mos.?
Doctor :   you can take macrodantoin
Doctor :   taking the antibiotic for such a long time can produce resistance
Doctor :   take it for 4 weeks and then redo the urine culture test
User :   how many mg. daily, and for how long? Plus, since I'm in peru, is that identical to macrodantina?
Doctor :   in case it is cleared , use a condom , as long as your husband has the infection
User :   is macrodantina (spanish) Macrobid or macrodantoin?
Doctor :   yes
Doctor :   all are one and the same
Doctor :   take macrodantina for 4 weeks
User :   but which? my internist said they're different, and I read the detailed flyer, and they are. maybe it's another variation on the spelling, but she said that one is for preventive, whereas Macrobid is for treating the infection.
Doctor :   and then re do the urine culture
User :   ok, but do we think that my partner definitely has a UTI also? my reading suggests that maybe it's just on the ring itself, and im thinking that maybe he doesn't have a UTI
Doctor :   macrodantina = nitrofurantoin
Doctor :   what i would advice u is to ask ur partner to remove the ring if possible
User :   yay for the translation. how many mg. .... 100 twice daily for 4 weeks?
User :   I will tell him to or he won't be my partner
User :   also, i should just tell him to get tested for a uti, don't you think?
Doctor :   yes
Doctor :   he should get himself tested too
Doctor :   for your information, you can also take macrobid 100 mg twice daily as this is a longer acting medication
Doctor :   macrodantina is a prep that u need to take 10 mg 4 times a day
User :   great, i think that covers everything. I'll do 4 weeks of macrobid 100 mg twice daily or if macrobid isn't available here, how much of macrodantina, but at what dose how many times per day, and then I'll get retested.
Doctor :   sorry it was 100 mg 4 times a day
User :   ok you just answered it, but did you mean 100, not 10?
Doctor :   for macrodantina
Doctor :   yes 100 mg macrodantina
Doctor :   and that is 4 times daily for macrodantina
User :   got it, macrobid 100 mg twice daily, or macrodantina 100 mg four times daily, correct?
Doctor :   but you will need a prescription for the same medication, i guess
Doctor :   yes that is right
User :   plus with food, or not, or does it matter¿?
Doctor :   no it does not
User :   And are we thinking that this longer than normal course is both taking care of the immediate infection, but also hopefully addressing the chronic issue too? Right?
Doctor :   yes
User :   That's it. Thank you very very much!!
Doctor :   you are welcome
User :   chao in español, ciao in italiano, chow in doggie
Doctor :   bye for now
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