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How To Treat Recurrent UTI?

Posted on Fri, 25 Apr 2014

Question: Female, age 63 with vaginal stenosis, atrophic vaginitis (menopause and chemo) but no other known factors. Regular CT scans for other purpose showed no abnormalities. Had uncomplicated UTI's twice since XXXXXXX with under 10,000 c. Treated with Keflex 1st time. 2nd time started Cipro but got hives and diarrhea so switched to 10 days Suprax. Completed that less than 2 weeks ago and yesterday had pubic pressure after nap as tho bladder was very full. Saw doc and dip stick shows no concerns (same as last time) but culture/ sensitivity sent out and won't be back til Thursday. Dr. gave me 500 mg Keflex 2 x's daily for 15 days this time. How can we stop these recurrent UTI's and rid me of KP? Bacteria was Klebsiella Pneumonaie

Answered by Dr. Dr. Soumen Patra (48 minutes later)

Brief Answer: DETAILS ARE GIVEN BELOW. FOLLOW ADVICE. Detailed Answer: Hello, Thanks for writing to us. Following are my comments: 1) We need CULTURE & DRUG SENSITIVITY test report in hand to determine better drug treatment because Klebsiella Pnuemoniae has recently developed resistance to many anti-microbial agents. Until then, you can take KEFLEX according to your doctor's prescription to be effective. PREVENTION: Most important preventive measure is HAND HYGIENE. Washing of hands is must before eating/ preparing food, after using toilet, changing dress, blowing nose/ sneezing/ coughing and before touching mouth/ eye/ nose. 2) FOR RECURRENT UTI: You can take URINE ALKALISER along with prescribed antibiotic. In addition, you must drink plenty of water (2.5 to 3 lit/ day), take cranberry juice regularly, maintain genital hygiene (during sexual activity also), empty bladder in time, avoid unprotected sex and wear clean-cotton dress only. Hope, it helps for your information. Kindly, close the discussion if you don't have any other query. Wish your good health and take care yourself. Regards, Dr Soumen For future query, you can directly approach me through http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=63326

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

Follow up: Dr. Dr. Soumen Patra (15 hours later)

Hi Dr. Soumen, Previously the KP was sensitive to sulfa drugs, Cipro type drugs, Ceflaxens (Keflex and Suprax are two I can name). My last c/s won't be back before Wednesday evening so hopefully I will have time left to report that back to you. You mentioned hand washing. Is this potentially XXXXXXX to my family? If urine were left on my hands or underwear and I were to load my washing machine and touch eyes, mouth, nose, etc. could I spread KP? No one has ever mentioned that before. I don't know what a URINE ALKALISER is so will have to research that. I am no longer sexually active (menopause and chemo plus an elderly husband of 44 years). If my laboratory reported KP counts of 10,000 - 50,000 (they are not more specific going next to 50 - 100 and then over 100,000) would / could that be indicative of me being colonized even tho I have urgency and pressure, discomfort above my pubic bone as symptoms? Thanks again for being available to answer my questions!

Answered by Dr. Dr. Soumen Patra (20 minutes later)

Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for follow up query. 1) HAND HYGIENE is must to prevent recurrent KP infection. According to previous drug sensitivity report, you can continue KEFLEX until you get new one report. 2) Branded URINE ALKALISER or one teaspoon of baking soda or Bicarbonate of soda helps to alleviate the discomfort of burning and scalding when passing urine. 3) In general, > 100,000 colonies/ ml on urine culture is diagnostic for UTI. However, the probability of a UTI depends on the method of collection. Lower colony counts may be obtained by sterile urethral catheterization or by suprapubic aspiration can represent TRUE infection. But, clean catch, mid-stream urine that harbors < 100,000 colonies/ ml in a female requires further verification or repeat sampling to confirm a UTI. Hope, I have clarified your query. Kindly, close the discussion. All the best and good luck. Regards, Dr Soumen

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

Follow up: Dr. Dr. Soumen Patra (29 hours later)

Culture and Sensitivity showed no bacteria so all set! Doctor did determine that I was constipated and gave me some recommendations for controlling that. Thank you for your help. I plan on following all your advice on hygiene, baking soda, plenty of water, etc. I appreciate your help and your concern!

Answered by Dr. Dr. Soumen Patra (5 minutes later)

Brief Answer: MOST WELCOME. Detailed Answer: Hello, You are most welcome in our Healthcare Magic platform. Kindly, close the discussion and rate the answer. Be well and take care. Regards, Dr Soumen

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