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How Can E.coli And Urinary Tract Infection Be Treated When Diagnosed With Diabetes, Hypertension, Thyroid Issues, Heart And Kidney Disease?
Question: Hi Doctor,
My mother is affected by urinary tract infection. She took the prescribed antibiotics (2 tablets per day) for 5 days as directed by nephrologist. But even after the 5 day course, she is not cured. The CUE test indicates the presence of bacteria and the urine culture and sensitivity test showed that the same bacteria (escherichia coli) that was detected earlier is still there.
Kindly suggest the next course of action.
The nephrologist suggested injections and told that he will confirm it after seeing the latest report. Do you think this is the best choice?
She is also affected by diabetes, hypertension, thyroid, heart disease and kidney disease.
Thanks and Regards,
XXXX
My mother is affected by urinary tract infection. She took the prescribed antibiotics (2 tablets per day) for 5 days as directed by nephrologist. But even after the 5 day course, she is not cured. The CUE test indicates the presence of bacteria and the urine culture and sensitivity test showed that the same bacteria (escherichia coli) that was detected earlier is still there.
Kindly suggest the next course of action.
The nephrologist suggested injections and told that he will confirm it after seeing the latest report. Do you think this is the best choice?
She is also affected by diabetes, hypertension, thyroid, heart disease and kidney disease.
Thanks and Regards,
XXXX
Brief Answer:
follow the advice...
Detailed Answer:
Hello,
I've gone through your query and understand your concerns for your mother,
I'm aware of her previous history and associated co-morbidities. Please note, E. Coli can be a notorious bug, and in her case, it can be a multi-drug resistant one...In such case, prolonged antibiotic therapy up to even several weeks and serial urine analysis at a repeated interval, to look for further progress, is recommended...
Another important finding is the pattern of sensitivity, I'd suggest you kindly upload the Culture and sensitivity report whenever available along with the current list of medications she's taking presently so that I can review them specifically and guide you further.
Yes, I do agree with her Nephrologist, not all antibiotics are available as an oral formulation and in case of multi-drug resistant E.Coli, injectable antibiotics needed to initiated to prevent any further complications...
So please go ahead with the treatment without any further delay...
Let me know if I can assist you further...
Take Care
Kind Regards
follow the advice...
Detailed Answer:
Hello,
I've gone through your query and understand your concerns for your mother,
I'm aware of her previous history and associated co-morbidities. Please note, E. Coli can be a notorious bug, and in her case, it can be a multi-drug resistant one...In such case, prolonged antibiotic therapy up to even several weeks and serial urine analysis at a repeated interval, to look for further progress, is recommended...
Another important finding is the pattern of sensitivity, I'd suggest you kindly upload the Culture and sensitivity report whenever available along with the current list of medications she's taking presently so that I can review them specifically and guide you further.
Yes, I do agree with her Nephrologist, not all antibiotics are available as an oral formulation and in case of multi-drug resistant E.Coli, injectable antibiotics needed to initiated to prevent any further complications...
So please go ahead with the treatment without any further delay...
Let me know if I can assist you further...
Take Care
Kind Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hi Doctor,
Thanks for your response.
She took the antibiotic duonem 200 mg (twice a day) for five days after the UTI was detected for the first time.
She is taking the following medications now.
Tab. Nexovas 10mg (once a day)
Tab. Nocidos DS (twice a day)
Tab. zytanix 2.5 mg (once a day)
Tab. Nefrosave Forte (once a day)
Tab. Dytor 10mg (once a day)
Ecospirin 150mg
Telma 40mg(The nephrologist asked her to stop this temporarily).
Clopitab 75mg (twice a day)
Aztor 40mg (once)
Thyronorm 100mcg
H.Mixtard (20ml - morning and 10ml - night)
Can you kindly suggest the antibiotics that she should take going forward? I would prefer if it is oral compared to an injection as it would mean depending on some one else twice a day to administer the injection. (My mother has put on a lot of weight after the chronic kidney disease and finds it difficult to climb the stairs and our house is on first floor.)
Thanks and Regards,
XXXX
Thanks for your response.
She took the antibiotic duonem 200 mg (twice a day) for five days after the UTI was detected for the first time.
She is taking the following medications now.
Tab. Nexovas 10mg (once a day)
Tab. Nocidos DS (twice a day)
Tab. zytanix 2.5 mg (once a day)
Tab. Nefrosave Forte (once a day)
Tab. Dytor 10mg (once a day)
Ecospirin 150mg
Telma 40mg(The nephrologist asked her to stop this temporarily).
Clopitab 75mg (twice a day)
Aztor 40mg (once)
Thyronorm 100mcg
H.Mixtard (20ml - morning and 10ml - night)
Can you kindly suggest the antibiotics that she should take going forward? I would prefer if it is oral compared to an injection as it would mean depending on some one else twice a day to administer the injection. (My mother has put on a lot of weight after the chronic kidney disease and finds it difficult to climb the stairs and our house is on first floor.)
Thanks and Regards,
XXXX
Brief Answer:
follow-up consultation...
Detailed Answer:
Welcome back,
Thanks for the details, I've reviewed the culture report...
Well, the culture pattern is showing pan-sensitivity, so, in my opinion, either of Norfloxacin/Levofloxacin (Orally) could be tried before opting for anything injectable...But, probably the Nephrologist is preferring injectable antibiotics as the UTI is persistent despite taking Duonem.
I'd suggest you discuss this with her Nephrologist. However, the final decision should be taken by the Nephrologist who's already handling her scenario and following up with her routinely...
Excessive weight gain can be due to CKD as well as Diabetes. The Urine output should be routinely measured along with strict vigilance on any other symptoms (breathing difficulty, swelling of the body etc). In case of inadequate urine output and a further worsening of symptoms, renal replacement therapy may be required.
The rest of the medications seem fine and should be continued as already advised.
Take Care
Kind Regards
follow-up consultation...
Detailed Answer:
Welcome back,
Thanks for the details, I've reviewed the culture report...
Well, the culture pattern is showing pan-sensitivity, so, in my opinion, either of Norfloxacin/Levofloxacin (Orally) could be tried before opting for anything injectable...But, probably the Nephrologist is preferring injectable antibiotics as the UTI is persistent despite taking Duonem.
I'd suggest you discuss this with her Nephrologist. However, the final decision should be taken by the Nephrologist who's already handling her scenario and following up with her routinely...
Excessive weight gain can be due to CKD as well as Diabetes. The Urine output should be routinely measured along with strict vigilance on any other symptoms (breathing difficulty, swelling of the body etc). In case of inadequate urine output and a further worsening of symptoms, renal replacement therapy may be required.
The rest of the medications seem fine and should be continued as already advised.
Take Care
Kind Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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