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What Causes Recurrent Urinary Tract Infections 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 (27 minutes later)
Brief Answer:
get the urine routine and culture tested.

Detailed Answer:
Hello XXXXXXX and welcome to HCM.
Well, like you, i too fail to understand, what really prevented doing a urine culture.
Only if the urine culture is positive, we call it an urinary infection, in which case, a course of antibiotic is enough to treat it.Frequency is typically a symptom of urinary infection, so get a urine routine and culture tested.Stop applying A and D ointment, and if you feel the dryness is severe, you should consult a gynecologist, who may advice a local estrogen ointment.
keep drinking 8-10 glasses liquids daily.Check your blood sugar and creatinine also.
Feel free to contact me with the reports.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Matthew J. Mangat (39 minutes later)
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:
culture is the definitive test to confirm infection.

Detailed Answer:
Hi XXXXXXX
Well routine urine test is not the same as culture.By and large, if urine is clear, one doesn't repeat the urine culture, unless person is having severe symptoms or fever.
But, a culture is the only definitive test to confirm infection.
Hope your doubts are cleared.Hope you've started the meditation routine.
Relax and don't worry.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Matthew J. Mangat (1 hour later)
The Dr. Said there was a mix up with culture. Not enough of a sample. She said I could come in and recheck the urine. I guess I will especially since I'm so concerned. I don't meditaybut I pray (yes u should have more faith!) And I have tried some relaxation techniques. Thankyou for your help. The symptoms do seem to be affected by stress (imagine that!)
doctor
Answered by Dr. Matthew J. Mangat (31 minutes later)
Brief Answer:
Good progress.

Detailed Answer:
Hi XXXXXXX
Good to learn you're going you're clearing the doubts of urinary infection finally, getting the culture test done.
Wishing there's no infection.Remember, Prayer is the greatest Healer.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Matthew J. Mangat (19 minutes later)
Yes it surely is. Thankyou
I went in for the urine test. It showed 25 wbc, no protein, everything else clear. She didn't want to treat it but wants to wait for culture so she can treat with the right thing. Does that sound right? Now I'm worried about other possibilities. Can it be irritation if no infection shows up? That's what my primarydoctor thought, then I went to this one.
doctor
Answered by Dr. Matthew J. Mangat (8 hours later)
Brief Answer:
No cause to worry.

Detailed Answer:
Hi again. XXXXXXX i told you earlier, routine and culture are different tests. Just wait 1 more day and your culture report is ready.
If there's no infection, don't worry anymore and just relax.
Be patient and enjoy life.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Matthew J. Mangat (1 hour later)
I'm trying to relax. Kind of concerned because it won't be ready for almost a week because of the holiday... 4th of July. Okay to wait that long? Drinking water and taking cranberry tabs.
doctor
Answered by Dr. Matthew J. Mangat (12 minutes later)
Brief Answer:
Relax thoroughly without the net.

Detailed Answer:
Hi XXXXXXX
My sincere advice to relax thoroughly is, get off the net.
8-10 glasses liquids of your choice daily.
No harm in waiting till reports are ready.
Take deep breaths regularly during meditation.
Enjoy life.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Matthew J. Mangat (2 hours later)
Okay, will do... Thanks so much
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
you're welcome.

Detailed Answer:
You're welcome.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (2 days later)
Do wbc always mean infection? Still having same symptoms but more relaxed.
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
good news.

Detailed Answer:
Hi XXXXXXX
It's great to read you're feeling relaxed.
Wbc is not infection. Bacteria is infection in significant numbers.
That's the reason, we ask for culture to diagnose infection.
Enjoy life while you can, in good health.
Hope you're off the net.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Matthew J. Mangat (51 minutes later)
Yes, more relaxed is better for sure. What does cause wbc? There was no protein or rbc or nitrites or glucose... Nothing else. That was 3 days ago, however. Tonight I have been up every 2 or 3 hours. Usually I can go 4 or 5 with this during the night. Longer when I didn't have this
doctor
Answered by Dr. Matthew J. Mangat (5 minutes later)
Brief Answer:
remain awake during daytime.

Detailed Answer:
Hi again. XXXXXXX wbc' are normally found in urine.So, don't worry.
Drink upto 8 glasses liquids ( not just water ), during daytime. At night after dinner, have only only 1 glass.
As you take walks and exercise or listen to music, meditate or read,your need to wake at night will come down for sure.
Keep yhis in mind and just relax.
Note: For further follow up on related General & Family Physician Click here.

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

Urologist

Practicing since :1981

Answered : 1898 Questions

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What Causes Recurrent Urinary Tract Infections Despite Taking Cephalexin?

Brief Answer: get the urine routine and culture tested. Detailed Answer: Hello XXXXXXX and welcome to HCM. Well, like you, i too fail to understand, what really prevented doing a urine culture. Only if the urine culture is positive, we call it an urinary infection, in which case, a course of antibiotic is enough to treat it.Frequency is typically a symptom of urinary infection, so get a urine routine and culture tested.Stop applying A and D ointment, and if you feel the dryness is severe, you should consult a gynecologist, who may advice a local estrogen ointment. keep drinking 8-10 glasses liquids daily.Check your blood sugar and creatinine also. Feel free to contact me with the reports.