I have had bladder infection after bladder infection on going
Detailed answer and explanations are given below
Urinary infections can be recurrent in women in menopause due to increased bacteriuria (presence of bacteria in the urine) at that age. It is very important every time you have symptoms of urinary infection (burning, frequency, low abdominal pain, back pain, fever) to have a urinalysis and a urine culture. The urinalysis will find signs of infection and the urine culture will identify the causing bacteria and the antibiotic that is going to treat it.
If you get recurrent infections with the same bacteria (urine culture can determine this) time after time then other examinations of the urinary tract are needed like ultrasound examination and cystoscopy to rule out stones, or tumours in the urinary tract.
If urine culture shows different bacteria each time then you will need to have a different approach:
1. The doctor might need to check for vaginal atrophy as this can cause increased urinary infections and the treatment is simple, with vaginal estrogens.
2. Cranberry extracts can be tried to help reduce urinary infection frequency
3. Your doctor might also consider daily low dose antibiotics at night for a long time. It needs to be low so it does not affect the bowel flora but enough to reach good levels in urine to cause prophylaxis of urinary infection. These would be ciprofloxacin 250 mg at night or Bactrim 480 mg at night or cephalexin 250 mg or nitrofurantoin 100 mg at night.
Macrobid that the doctor has given you is nitrofurantoin and is found to be very good to prevent urinary infections so I would encourage you to continue it as your doctor prescribed it.
- recurrent urinary infection is common after menopause
- urinalysis and culture are needed in the evaluation
- if the same bacteria is isolated each time then you will need other tests like ultrasound and cystoscopy
- if different bacteria are isolated in each urinary infection you experience then no other tests are generally needed but the doctor can try to prescribe: vaginal estrogens and an antibiotic in low dose at night, you may also use cranberry extracts to help.
Hope I have answered your query. Let me know if I can assist you further.
Dr. Antoneta Zotaj
General & Family Physician
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