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Cloudy urine and vaginal itching. Should I increase the dosage of cefuroxime as there is no change?

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Hi,
I had uti symptoms, cloudy, smelly pee and slight vaginal itch but no discharge.
I took a single dose of 1000mg cefuroxime in fear of gonerrhea last week.
Symptoms went away for a few days and came back. I was instructed to get back on cerufoxime for 7 days. So i have been doing 250mg bd for 3 days now but the symptoms are not going away.
Should i up the dose?
Posted Mon, 18 Nov 2013 in Urinary and Bladder Problems
 
 
Answered by Dr. Rakesh Karanwal 15 minutes later
Brief Answer:
Get urine culture/sensitivity

Detailed Answer:
Hi XXXX,

Thanks for your query.

* Urine infection is most commonly due to bacteria or fungus. The best way to know the causative agent is to get urine examination, culture/sensitivity test done, which isolates the organism, including Gonococci, and also shortlists most effective antibiotics. Use of one of the short-listed antibiotics for at least 7-10 days will cure UTI.

* Cefuroxime should be taken 500mg thrice daily for at least 7 days-10 days to completely eradicate the infection.

* If fungus is isolated, a course of anti-fungal drugs, such as Fluconazole, will eradicate the infection.

Dr. Rakesh Karanwal
Above answer was peer-reviewed by
 
Follow-up: Cloudy urine and vaginal itching. Should I increase the dosage of cefuroxime as there is no change? 2 hours later
That's a very high dose! Would it affect my sensitivity to antibiotics in the future?
Can i take cerufixime and fluconazole at the same time? Fluconazole - 150mg single dose enough?
 
 
Answered by Dr. Rakesh Karanwal 1 hour later
Brief Answer:
Your current dose is that used in children!!

Detailed Answer:
Hi XXXX,

Thanks for your clarification.

* The effective dose of cefuroxime in ADULTS is 500-750mg THRICE daily, while in children is 250mg THRICE daily.

* Hence, you will NOT get relief with PEDIATRIC DOSE!! On the contrary, inadequate dose of an antibiotic or, ADULT dose for INADEQUATE period, is the MAIN CAUSE of development of resistance to that particular antibiotic in an individual. No wonder, in the present times, harmful bacteria have become RESISTANT to MOST of the antibiotics (even the LATEST/ULTIMATE and most expensive).

* I therefore STRONGLY advise that you take the recommended dose. Rest assured that it not effect your sensitivity to this antibiotic in future, for the reason given above.

* Lastly, fluconazole can be taken along with cefuroxime. The recommended dose is 150 DAILY for 7-10 days (nothing short of that). However discuss with your treating doctor before you try the combination.

Hope this helps. If you have an further clarifications, I will be more than happy to address it.

Regards,

Dr. Rakesh Karanwal
Above answer was peer-reviewed by
 
Follow-up: Cloudy urine and vaginal itching. Should I increase the dosage of cefuroxime as there is no change? 4 days later
Most symptoms are gone but my pee still has a strong odor. I drink lots of fluids and also cranberry juice. Still on cerufixime 500 mg tid on my 6th day. I ran out of fluconazole and only took it for 3 days. :-(
 
 
Answered by Dr. Rakesh Karanwal 8 hours later
Brief Answer:
Full course of treatment will cure your problems

Detailed Answer:
Hi XXXX,

Thanks for the feedback.

You have a mixed infection (bacterial + fungal) of genito-urinary tract.

As mentioned earlier, I had advised you to take fluconazole for, at least 10 days. PLEASE CONTINUE IT WITHOUT ANY BREAK.

Cefuroxime too, should be taken for 10 days. And, don't worry : the urine odor will also go away, once the treatment is completed. Stop cranberry juice till the treatment is complete.

Remember : the target is to KILL each and every bacteria + fungi. They multiply very rapidly. So, even if a single bacteria or fungi survive due to inadequate duration of treatment, they will soon multiply and there will be recurrence of UTI. That will mean : DOUBLE THE EXPENDITURE on medications, as well as, longer duration of problems!

Add Metronidazole 400mg thrice daily for 7 days (for vaginal infection).

Revert back to me on completing the course of all drugs as advised by me.

Hope I have answered your query. If you have no further clarifications, you may close the discussion and rate my answer.

Regards,

Dr. Rakesh Karanwal
Above answer was peer-reviewed by
 
Follow-up: Cloudy urine and vaginal itching. Should I increase the dosage of cefuroxime as there is no change? 5 days later
Finish cefuroxime course (10days). On my sixth day of fluconazole. Urine still smells and is cloudy.
 
 
Answered by Dr. Rakesh Karanwal 53 minutes later
Brief Answer:
Please send the urine test report at the earliest

Detailed Answer:
Hi XXXX,

Nice hearing back from you. I sincerely hope that the UTI symptoms must have disappeared by now. You have not mentioned if you are taking Metronidazole 400mg thrice daily for 7 days, as advised for vaginal infection.

Please note that an online doctor opines on the basis of the information provided.

As such, cloudy urine can be due to other causes too, apart from UTI. That's the reason why I had advised you to get your urine analysis done along with its culture/sensitivity test. You haven't mentioned the test report, which would have given me plenty of information.

Further, at times, it may be tell whether the smell is from urine or from vagina. So, it's first important to determine the source of smell. An easy way to check is to pee into a cup and wait a few minutes. If the odor is still present it is most likely related to urine. If it disappears, a vaginal source would be suspected and may be the result of an infection.

Don't worry. First send me the report at the earliest.

Till such time, continue with Fluconazole for a total of 10 days. If it was indeed UTI, all signs and symptoms will disappear by the time you complete the 10-day course of Fluconazole.

Awaiting the test report.

Regards,

Dr. Rakesh Karanwal
Above answer was peer-reviewed by
 
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