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Suggest medication for UTI

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Posted on Thu, 19 May 2016
Question: For advice of specifically Dr XXXXXXX XXXXXXX XXXXXXX Consultant Urologist & XXXXXXX
Respect Sir,
Good Morning
I am XXXXXXX XXXXX, Male / 53 Years - Married
I have been suffering from following Urination Problem for last couple of months :-
(a) Frequent urge of urination
(b) Sometimes, even in case of strong urge and sufficient urine holding, it takes huge time to take a start and always ends after continuous dropping for long time.
(c) Urination flow is very poor and thin for last long period.
(c) So I increase quantity and frequency of water taking, frequency of urination increases.
(d) Almost within every half-one hour I get urge of urination after complete voiding and gradually urge becomes very irritating until I go to urinal and void it.
(e) After every urination I feel some relief and comfort.
(f) Problem is much in the evening.
(g) I had significant Prostate enlargement (Prostetomegally Grade I) and PV residual urine one year before also when I did not have any Urine infection. I took only Tablet Urimax 0.4mg ODHS for couple of months as advised by one local general physician.
I do not have till now /did not have earlier also :-
(a) Any pain in the abdomen, lower or upper.
(b) Fever or feverishness or fatigue.
(c) Any problem while sleep at night.
(d) Habit of alcoholic drinks.
(e) Burning sensation in the urinary tract & Urine is always crystal clear / no colour.
I have consulted a Specialist General Physician. He has carried-out Blood/Urine Tests(CBC/TSH/FBS/Na/K/Ca/Creatinine), USG(Whole Abdomen) , Urine RE & CS.
I have been taking Homeopathy medicines for last more than 15 days, but very minimum relief I am getting.
Some major features of Pathological Reports :-
(a) USG - Rt renal calculus - 4mm, P/V residue of urine - 63ml
(b) Urine - Pus Cell(WBC) Plenty, Culture - Staphylococcus aureus
(b) ESR - 1st hous 21mm/hr
Contdā€¦P/2


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I have consulted yesterday Dr XXXXXXX Taher XXXXXXX General Physician through this online doctor's service of 'Healthcare Magic' His advice which I have received couple of hours back is appended below for your easy reference : -

" Brief Answer:
Suggestive of UTI.

Detailed Answer:
Dear Sir, Hi & Welcome.
Thanks for posting your query on Health care magic.
After having gone through your history and the uploaded results of Urine analysis & its culture and sensitivity test, Hemogram, blood glucose test, and the abdominal ultrasound scan I am of the opinion that you seem to have urinary tract infection secondary to the renal calculus (stone in the right kidney).
Had you been my patient I would have advised the following treatment:
1. The antibiotic Ciprofloxacin 500 mg twice daily for 14 days.
2. To increase the oral fluids so as to maintain a good urine out put.
3. For the kidney stone and urinary urgency a urologist consultation is recommended for further evaluation of ?prostatic enlargement.
Hope the suggestions given would be useful in eradicating the infection.
However if you have any follow up query, you may please send it.
Best wishes. "

I have not yet taken any antibiotic or others and I did not go to the local Specialist Physician with the reports. I want a complete course of medication with number of medicines as less as possible but compulsory for quick relief.
I do have a long relation of online service with doctors of 'Healthcare magic' and got very effective advices from different doctors for myself and my wife in different cases of last more than 2 years.
Please advise me exact medicines as minimum as required but effective. I know UTI and renal calculus may be dangerous if not treated well and as early as possible.
I enclose herewith the Test Reports for your perusal and easy diagnosis.
Thanking you, with regards
XXXXXXX XXXX, 11/03/2016, SILIGURI(WB)
doctor
Answered by Dr. Matthew J. Mangat (1 hour later)
Brief Answer:
Prostate gland enlargement with UTI.

Detailed Answer:
Hello XXXXX and welcome to HCM.
As an Urologist, i can fully understand your concern.
XXXXXXX has an enlarged prostate gland,with UTI(urinary infection).
He'll need treatment for both.

His blood,urine and scan are confirmatory of this diagnosis.
Certain tests have not been done as follows :.
1. PSA
2. LFT.
3. urine flow rate.

Stop the homeo treatment, as it's not effective.
Let him start Tamsulosin with combination of dutasteride, or Alfuzocin, once daily.
This will give him more relief, than Tamsulosin alone, which he discontinued.

Kindly ask him to undergo the tests and start treatment as advised.
Send the test reports.
Tell XXXXXXX not to worry and to drink only 8-10 glasses fluids daily.

Wishing him good health.

Dr,Matthew J. Mangat.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Matthew J. Mangat (57 minutes later)
Respected Sir,

Thanks for your valuable advice.

I have further queries as follows :-

(a) However I feel you have missed to note that there is Right Renal Calculus of
4 mm in size and there is no prostate enlargement as USG report shows.

(b) Regarding medicine to start right now is it Urimax-D or give me the Brand
name of the medicine and dosage for Tamsulosin with combination of
dutasteride, or Alfuzocin.

(c) Should I not start 'Ciprafloxacin 500mg as suggested by General Physician Dr
XXXXXXX Taher XXXXXXX which I have already mentioned. If yes, whether it is
'Ciprafloxacin XR' would be better to treat the infection.

(d) As fluid intake is concerned, I saw frequency, urgency and quantity of urine
increases abnormally if I take adequate drinking water and that is a great
problem as of now.

Please review your advice and get back me once again as early as possible .

With regards, thanking you
XXXXXXX XXXXX. 11/03/2016
doctor
Answered by Dr. Matthew J. Mangat (44 minutes later)
Brief Answer:
stone should pass spontaneously.

Detailed Answer:
Hello XXXX,

a) The 4mm renal(kidney) stone, is very small and should pass spontaneously.
Usually, we advise people to increase fluids. to 12-15 glasses daily.
But, in case of XXXXXXX his prostate gland obstruction,will increase the frequency.
Let him also start a syrup of potassium magnesium citrate, for dissolution of stone.
Small size stones of this size, don't affect the kidney and pass spontaneously.

b) Either of them is fine. You'll need to get the prescription from your local doctor or licensed pharmacist.
This also helps in passage of stone into bladder.

c) He'll need to start an antibiotic course, as he has active infection.
Ciprofloxacin is sensitive and can be started.
Plain form is sufficient.
d) Hope the answer in a), has cleared your question.
The treatment for prostate gland obstruction, should also help in passage of
stone.

Wishing you good health.

Dr.Matthew J. Mangat.



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Matthew J. Mangat

Urologist

Practicing since :1981

Answered : 1898 Questions

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Suggest medication for UTI

Brief Answer: Prostate gland enlargement with UTI. Detailed Answer: Hello XXXXX and welcome to HCM. As an Urologist, i can fully understand your concern. XXXXXXX has an enlarged prostate gland,with UTI(urinary infection). He'll need treatment for both. His blood,urine and scan are confirmatory of this diagnosis. Certain tests have not been done as follows :. 1. PSA 2. LFT. 3. urine flow rate. Stop the homeo treatment, as it's not effective. Let him start Tamsulosin with combination of dutasteride, or Alfuzocin, once daily. This will give him more relief, than Tamsulosin alone, which he discontinued. Kindly ask him to undergo the tests and start treatment as advised. Send the test reports. Tell XXXXXXX not to worry and to drink only 8-10 glasses fluids daily. Wishing him good health. Dr,Matthew J. Mangat.