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Suggest Treatment For Recurrent And Drug Resistant Urinary Tract Infection

Posted on Fri, 25 Jul 2014

Question: Hi
Thanks Dr. for the reply. But after culture is done, Dr has given him injections antibiotic that came in culture report. After that for 2-3 week he was fine. I think in 4th week again he started feeling same symptoms like chill, than today he again had first fever 99.7C than 101.8C. Why is he again and again coming back though we have given him culture anti bacterial injection.

Thanks
XXXXXX

Answered by Dr. Roopa Hiremath (2 hours later)

Brief Answer:
Recurrent and resistant UTI

Detailed Answer:
Hi Mr. XXXXXXX

Thanks for choosing health care magic.

I have gone through your query and also the previous queries you have asked about your father's problem.

I am suspecting recurrent and drug resistant urinary tract infection in your father's case as he has prostate enlargement which predisposes him for urinary infection.

He will require repeated urine culture and sensitivity to determine the bacteria causing infection and the antibiotic to which it is sensitive.

Unfortunately, bacteria which cause urinary infection develop resistance very easily and become difficult to treat.

I suggest you get another urine culture and sensitivity and discuss with his treating doctor a combination of antibiotics which can be more effective than a single drug.

For now, based on his symptoms in your query, he has to be put on another course of antibiotics as he is getting repeated urinary infections.

Following tips can be followed to prevent recurrence:
1. Drinking at least 3-4 liters per day.
2. Proper toilet of the genital area and maintenance of personal hygiene.
3. Drinking cranberry juice or cranberry extract reduces the frequency of recurrent UTIs.
4. Long term low dose prophylactic antimicrobial treatment can be tried but this option has to be discussed with his treating doctor.

I hope I have helped you with this answer.

Please get back if any more clarifications.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Roopa Hiremath (2 hours later)

Hello Dr. XXXXXXX

Thanks for quick reply.
My father is also suffering from back bone and shoulder fracture, because of that Dr. has advised him not to sit and lie straight only. That is the reason we could not take him to XXXXXXX to other hospitals. Can't we have the permanent cure of this problem, because when he suffer from fever he sometimes start speaking out of his sense, ie. he loose his sense. Today urine complete test showed 50-60 pus cell.

As per your email is this the only way to get repeated culture when ever he suffer from urine infection, until unless bacteria is completely destroyed.

Thanks
XXXXXX

Answered by Dr. Roopa Hiremath (14 hours later)

Brief Answer:
Repeated urine culture, neurology consult required

Detailed Answer:
Hi Mr. XXXXXXX

Welcome back.

I apologize for the late reply.

I understand your concern regarding your father's clinical condition and I am very sorry to hear that he is bed ridden.

Is he being catheterized for passing urine? because if he is, then he will be predisposed to urinary infection due to the urinary catheter.

Repeated urine culture and appropriate antibiotics have to be given until the infection is cured.

You have also mentioned that your father gets disoriented when he has fever.

Is he having any other symptoms like memory loss, delusions and hallucinations when he is not having fever?

As your father is 70 years old, I would suggest you get a neurology consultation as old people start getting symptoms like memory loss, disorientation which are suggestive of impending Alzheimer's or senile dementia.

I hope I have helped you with this answer.

Please let me know if I assist you further.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Roopa Hiremath (9 minutes later)

Thanks Dr. XXXXXXX
Please find my answer inline :

Is he being catheterized for passing urine? because if he is, then he will be predisposed to urinary infection due to the urinary catheter.
# It was used for the very first time when he had this urine infection. I mean last month 25 May. And that was used because that time it was 60-65 puss cell and he was not able to walk to pass urine. Now it is not being used.

Repeated urine culture and appropriate antibiotics have to be given until the infection is cured.
# That mean this is the only cure, right Dr. or do you think if we consult to some other Dr. It might help us ?

You have also mentioned that your father gets disoriented when he has fever.
# Yes I mean to say yesterday and before also we have observed he start speaking some thing e.g. he will say that medicine was not given, though the medicine was given already or other is like he will say what is my don flat dimension, though I haven't purchased flat. But after fever is down we see him as normal. My doubt is, may it happen because of this urine infection fever also, is this be as one of the symptoms.

Is he having any other symptoms like memory loss, delusions and hallucinations when he is not having fever?
# He is having his head nerve compressed, I m not sure which side. For that the treatment is going on from past 1 yrs.

As your father is 70 years old, I would suggest you get a neurology consultation as old people start getting symptoms like memory loss, disorientation which are suggestive of impending Alzheimer's or senile dementia.

Answered by Dr. Roopa Hiremath (22 minutes later)

Brief Answer:
Antibiotic prophylaxis can be tried

Detailed Answer:
Hi Mr XXXXXXX

I would suggest you get in touch with his treating doctor and discuss options about giving him long term low dose antibiotics so that he does not have recurrence of infection.

But this option can be tried only when very necessary, that's why I am suggesting you first discuss this with his present doctor.

If he is being treated for neurological problems, I would suggest you mention these new symptoms of memory loss and disorientation to his neurologist.

You can get a screening test done to rule out Alzheimer's or senile dementia.

This test consists of simple questions about his routine activities and his thinking capabilities.

Based on the answers of these questions, he will be scored to rule out Alzheimer's disease.

I hope I have cleared your doubts.

Wishing your father a speedy recovery.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Roopa Hiremath (1 minute later)

Thanks Dr. Wil come back in case any more doubts.

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer:
Please get back if any clarifications

Detailed Answer:
Mr. XXXXXXX

Please get back if any more doubts.

Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Roopa Hiremath (23 hours later)

Hi Dr. XXXXXXX

Now urine is passing fine, but he has started feeling since yesterday that urine is about to pass but it doesn't come in between. Do you suspect it might be because of we started giving him cranberry juice also ? Is this one of the side affect of giving cranberry juice.

If not, can you please suggest me in this case what could be best to avoid these situation.

XXXXXXX

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer:
Unlikely to be due to cranberry juice

Detailed Answer:
Hi Mr. XXXXXXX

Welcome back.

I am glad to hear that your father is feeling better.

He is suffering from increased frequency and incomplete voiding of urine which is common in urinary tract infections and in prostate enlargement.

He will feel better within a day a two once the infection is in control.

This is not caused due to cranberry juice.

Cranberry juice is pretty safe with minimal side effects and prevents urinary infections by chemicals present in them which keep bacteria from sticking to the cells that line the urinary tract where they can multiply.

Wishing your father a speedy recovery.

Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Roopa Hiremath (39 minutes later)

Thanks Dr.

I will keep coming back as and when any doubt.

XXXXXXX

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer:
Feel free to ask queries at our forum

Detailed Answer:
Hi Mr. XXXXXXX

You can get back with your query and I will try to help you as much as possible and as soon as possible.

Thanks.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vaishalee Punj