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What Causes Recurrent UTI Despite Taking Cephalexin?

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Posted on Wed, 22 Jul 2015
Question: I communicated, quite extensively, with you a few days ago. It was regarding being treated for a uti with cephalexin but still having symptoms. I told you at the time that I was waiting on the urine culture. The first urine, taken 9 days ago had shown 75 wbc, 100 protein and no nitrites. 4 days on antibiotic and it showed nothing but symptoms of frequency and discomfort remained. As it turned out, they never sent the urine for culture. They can't tell me why and the Dr has not returned my calls even thought her assistant assured me that she would. I'm not sure what to do. These symptoms are very disturbing. Should I get urine retested? Does it matter that no culturewas performed after all? The Dr said, after the second urine and test that she would let me know if there was a need for different meds... All the while the culture had never even been done! The symptoms now are frequency (though I really do have urine) and there is tingling discomfort during (especially when I need to urinate and at beginning of stream) and often in between. I've tried A andD ointment just to see if it's dryness, irritation. Doesn't do much. In fact, at night it usually is alot better but last night it wasn't and that's after using the ointment all day.
doctor
Answered by Dr. Matthew J. Mangat (56 minutes later)
Brief Answer:
Get urine routine and culture tested.

Detailed Answer:
Hi XXXXXXX again.
Urine culture is the basis for diagnosing and treating an urinary infection.
I'm surprised it wasn't done earlier.Any way, now you get a urine routine and culture done.Also, check your blood sugar and creatinine.
Let me know the reports.Till then, keep drinking 8-10 glasses liquids daily.
Stop using the ointment.If the dryness bothers you a lot, see a gynecologist, who will decide, whether you need an estrogen cream locally.
Wish you well.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Matthew J. Mangat (42 minutes later)
I have an email saying that the second question was answered but it isn't here.
I don't think my second question was ever seen by you as I'm not seeing it on the website. I see different answers to the same question. My second was as follows :
I wondered of you looked at our lengthy discussion on Saturday and Sunday. At the time, I explained that I had had the urine tested on the 23rd with 75 wbc and 100 protein. The culture was suppose to be done then. I asked for it. The Dr. Just treated with cephalexin 7 days bid. 500mg. I returned on the 26th. They redid the urine and it was perfectly clear. So the Dr was unconcerned with the culture because of that. However, I still had, and have, some frequency (though I do drink 2 to 3 liters of water a day) and some discomfort especially when I need to urinate and at the beginning of stream. It often continues to feel irritated. However, as I had explained to you, I am wildly focused on it and extremely anxious. At that time, you reassured me that, with clear urine, I should relax and that I was causing it by my anxiety. If the urine is clear, is there still reason to culture? I'm confused about and thinking I didn't make myself cclear and you're answering this as a brand new question.
Btw, urine was neg for glucose and my a1c has always been good. Creatinine last time was 1.1 then later 1.0
I found the second question. There is no answer after it:

Did you look at the other questions we discussed a few days ago? At that time, you said that if the white cells and protein were gone on the second urine test then the infection was gone and I should quit worrying. You thought it was anxiety and assured me not to stress. The culture was supposed to have been done on the first culture that had the wbc and protein. You, at that time seemed unconcerned with how the culture turned out as the next sample, after a few days on antibiotics, was all clear of wbc and protein. Now I'm really confused. You told me to relax and quit checking urine if no wbc or protein. anymore. So should I think that there's still an infection if the regular urine was clear a few days ago? If they had cultured the first urine, no matter how it came back, what would it mean if urine is now clear? If I get a repeat urine and it's clear of alleevidence of infection, does it still need culture?
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
Relax and enjoy life.

Detailed Answer:
Hi XXXXXXX
All answers are knowing very well, your concern about urinary infection.
Maintain 8-10 glasses of liquids daily. It helps prevent a recurrence of urinary infections.
Hope you've started the meditation schedule for 20-30 minutes daily.
Hope your doubts are cleared now.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1898 Questions

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What Causes Recurrent UTI Despite Taking Cephalexin?

Brief Answer: Get urine routine and culture tested. Detailed Answer: Hi XXXXXXX again. Urine culture is the basis for diagnosing and treating an urinary infection. I'm surprised it wasn't done earlier.Any way, now you get a urine routine and culture done.Also, check your blood sugar and creatinine. Let me know the reports.Till then, keep drinking 8-10 glasses liquids daily. Stop using the ointment.If the dryness bothers you a lot, see a gynecologist, who will decide, whether you need an estrogen cream locally. Wish you well.