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Recurring UTI. Taking alprim. Is the medicine correct?

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Practicing since : 1991
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Hi I have a uti and am taking alprim but burning is getting worse. I've been taking it for 6 days. I have reoccurring uti, do everything to prevent them but it does work. The hospital just keeps telling me to finish the course then come back but last time I had two courses and still didn't feel 100%.
Mon, 10 Dec 2012 in Urinary and Bladder Problems
Answered by Dr. G.Srinivasan 56 minutes later
Welcome to XXXXXXX and thanks for your query.

Recurrent UTI needs step-wise evaluation to look for a possible cause and treat accordingly.
In your place, being an advanced country with wonderful medical facilities, the following things would have been done or being planned shortly. Mine is just to make you aware of the approach, in case it has not been explained to you.

The approach is divided into many steps.

1.     Treatment of the current episode.
2.     Prevention of recurrence.
3.     Looking for a possible cause.
There may be some overlap, but the above is the sequence of approach.
Let me discuss the issues gradually.

Treatment of the current episode.
1.     Antibiotics in full dose for 7 to 10 days based on culture report.
2.     Low dose antibiotics for 3 to 6 months in about half the dose ( the same one that was used).

Looking for a possible cause.
1.     Ultrasound scan or CT SCAN is necessary to look for stone or block in the urinary tract.
2.     IVP or urography will show the urinary tract as a whole and will be useful to look for a possible cause.
3.     Cystoscopy to look at the bladder.
4.     Uroflowmetry to check flow may be necessary to look for a possible obstruction to the urine flow.

Prevention of recurrence.
1.     Plenty of oral fluids - the essence is to drink before one is thirsty.
2.     Emptying the bladder at bedtime.
3.     Emptying the bladder before and after sex.

Kindly speak to your doc on these issues and get well soon.

Wishing you good health
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