Suggest treatment for antibiotic resistant UTI

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Posted on Mon, 11 May 2015 in Infections
Question: I've had this chronic UTI for over 20 days now .. I even took Nifats 100 mg twice daily for 7 days before which Levomac never helped. I got my culture done its E.coli >10^5CFU/ml
as per urine routine appearance of urine is slightly turbid, trace of albumin found, pus cells 10-20, and epithelial cells are 4-6 (everything else normal)
Symptoms are - hot urine, slow urination and little white discharge
my UTI has become antibiotic resistant and is only sensitive to AMIKACIN, COLISTIN, GENTAMICIN, IMIPENEM, MEROPENEM, NITROFURANTOIN and POLYMYXIN B
now my doctor tells me to continue NIFTAS 100mg for 15 days twice a day and one OD CRANPAC (Cranberry supplement)
Is that alright or shall i see another Urologiest or change meds
doctor
Answered by Dr. Tushar Kanti Biswas 1 hour later
Brief Answer:
Chronic UTI

Detailed Answer:
Hi,

Thank you for your query. I can understand your concerns.

Since your urine culture shows E.coli with growth 1 lacs colony forming unit /ml[significant bacteriuria(CFU/ml)] and sensitive to Niftas(Nitrofurantoin ),it is quite logical to continue Niftas for 15 days,since you are having chronic UTI but the dose is 100 mg three times a day and you have to take for at least 3 days after sterile urine is obtained.

Hence you need to repeat your urine culture at least three days before completion of the course.
Nitrofurantoin remains highly active against E. coli .Resistance to nitrofurantoin remains low despite >60 years of use. Since this drug affects bacterial metabolism in multiple pathways, several mutational steps are required for the development of resistance. Hence your doctor has preferred Nitrofurantoin over other antibiotics/urinary antiseptics.


Nitrofurantoin however does not reach significant levels in tissue and cannot be used to treat pyelonephritis i.e complcated UTI.

CRANPAC (Cranberry supplement) is only supporting drug.

Regards

Dr. T.K. Biswas M.D. XXXXXXX

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
Dr.
Dr. Tushar Kanti Biswas

Internal Medicine Specialist

Practicing since :1975

Answered : 1909 Questions

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