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Have recurrent urine infection, ofloxacin and linezolid doesn't help. Microbiology report showed growth of Escherichia Coli. Suggest?

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General & Family Physician
Practicing since : 2009
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hi, my wife have repeated urine infection since post married life, for last 10 years, antibiotics taken and cured but again infected within three to six months, its getting chronic disease now, last microbiology report shows : growth of escherichia coli with colony count 0.55x10 5 cfu/ml urine. resistant antibiotics are ofloxacin and linezolid and itermediate are sparfloxacine rest are sensitive. infections repeat mostly after intercourse. please suggest me long term cure of urine infection,
Posted Tue, 3 Sep 2013 in Urinary and Bladder Problems
 
 
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer:
Need culture report

Detailed Answer:
Hello sir and welcome.

I can understand your frustration towards the recurring infection. But I will require your help, so I can help your wife.

Please attach the latest (most recent) urine culture and sensitivity report to our conversation or you could even type it out here; so I can decide the most sensitive and effective antibiotic. I will also decide the dosage and duration for the particular antibiotic.

In the meantime, please initiate SYRUP CITRALKA (2 teaspoons three times a day), plenty of fluids. I will suggest the antibiotic once you write back to me with the urine culture report. It is also important for you and your wife to abstain from all forms of sexual contact for at least 7 days after the last dose of medication.

Hope this helps sir. Awaiting your response.

Take care.
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Follow-up: Have recurrent urine infection, ofloxacin and linezolid doesn't help. Microbiology report showed growth of Escherichia Coli. Suggest? 8 hours later
Last urine culture report dtd 20/07/2013
sediment:absent
reaction:acidic
pH:6.0
albumin:present
glucose:nil
bile pigment:nil
bile salt:nil
occult blood:nil
epithelial cell:4-6/hpf
pus cell:6-8/hpf
R.B.C:nil
crystais:nil
casts:nil
bacteria:present(+)
Sensitive antibiotics as per last sensitivity report dtd 23/07/2013.
amikacin,gentamycin,azithromycin,moxifloxacin,cefoperazone,sulbactam,piperacillin,tezobactum,levofloxacin,cefotaxime,nitrofurantoin.......
last time i had taken levofloxacine for 5 days, please suggest me mild dose but long term antibiotics course so that bacteria can resolve permanently.
 
 
Answered by Dr. Shoaib Khan 3 hours later
Brief Answer:
Nitrofurantoin sustained release 100 mg

Detailed Answer:
Hello sir and thank you for the information.

If I am your treating physician I would initiate a course of tablet NITROFURANTOIN for the next 14 days. Since this is a prescription based medication (you may be allergic to if taken for the first time) I do suggest to XXXXXXX the local doctor for prescribing it and regular monitoring.

The reason why I suggest antibiotic for 14 days is because your wife has a recurring infection. Do not discontinue the medications, even if she starts to feel better. Request your wife to drink plenty of water.

I also request you to write back to after your local doctor prescription on the last day (i.e. the 14th day); explaining her response and general condition. Please also abstain from sexual intercourse during this period and for at least 7 days after the last dose of medication.

I wish your wife a speedy recovery and a healthy life thereafter.

Best wishes.
Above answer was peer-reviewed by
 
Follow-up: Have recurrent urine infection, ofloxacin and linezolid doesn't help. Microbiology report showed growth of Escherichia Coli. Suggest? 3 hours later
Please note that my wife already experience NITROFURANTOIN 400mg x 5 days for her previous infection and the medicine experiencing lots of allergy with rash. so please give some anti allergy with these medicine or change the antibiotic if possible for goodness. thanks once again
 
 
Answered by Dr. Shoaib Khan 26 minutes later
Brief Answer:
Moxifloxacin tablets would be the next best choice

Detailed Answer:
Hello sir.

In that case, if you wish to use tablets and I were your physician the next best option would be to use MOXIFLOXACIN tablets x 14 days. Please do not forget to write back to me on the 14th day of your course with your wife's general condition and response.

Wishing your wife a speedy and effective recovery.

Best wishes.
Above answer was peer-reviewed by
 
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