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Suggest Treatment For Recurrent Severe UTI
Question: I had sever UTI about a month back with vomiting n fever.Dr. had a culture and routine test of urine which revealed a infection by E coli.I was put on Niftas 100 for 10 days 2 tabs daily. I recovered soon ,but as i stopped medicine after 4-5 days again mild infection urinary troubles started. Now iam taking 50 mg niftas twice daily for 3-4 days n recovering. What shall i do , iam afriad if i stop medicine i may get full blown UTI again !And when tht happens anything i eat vomits.
Brief Answer:
Recurrent UTI
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You have 'Relapsing' / 'persistent' infections due to the continued presence of probably the same organism (E.coli), suppressed or not suppressed during your antibiotic therapy.
It indicates abnormal host defenses, usually due to abnormal anatomy or function of the urinary tract.
You need to undergo Ultrasonograpy (USG)of kidneys ,ureters,bladder & prostrate to rule out any stasis in urinary tract due to obstruction (anywhere from the Renal Pelvis to the tip of the Urethra),usually renal/ureteric stones at your age.
You need to check your blood sugar (fasting & post-prandial) also to rule out Diabetes which usually makes a person prone to recurrent UTI.
One way to prevent recurrent UTI is to increase fluid intake (at least 2 litres per day) and frequency of voiding,
High fluid intake alone is often enough to clear symptomatic infection.
Incomplete voiding is also an important cause of increased susceptibility to urine infection.
The prostate is also involved in the majority of cases of febrile UTI in men, the goal in these patients is to eradicate the prostatic infection as well as the bladder infection.
Antibiotic therapy is tailored to urine culture results and is be continued for 2–4 weeks.Otherwise UTI tends to recur.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Recurrent UTI
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
You have 'Relapsing' / 'persistent' infections due to the continued presence of probably the same organism (E.coli), suppressed or not suppressed during your antibiotic therapy.
It indicates abnormal host defenses, usually due to abnormal anatomy or function of the urinary tract.
You need to undergo Ultrasonograpy (USG)of kidneys ,ureters,bladder & prostrate to rule out any stasis in urinary tract due to obstruction (anywhere from the Renal Pelvis to the tip of the Urethra),usually renal/ureteric stones at your age.
You need to check your blood sugar (fasting & post-prandial) also to rule out Diabetes which usually makes a person prone to recurrent UTI.
One way to prevent recurrent UTI is to increase fluid intake (at least 2 litres per day) and frequency of voiding,
High fluid intake alone is often enough to clear symptomatic infection.
Incomplete voiding is also an important cause of increased susceptibility to urine infection.
The prostate is also involved in the majority of cases of febrile UTI in men, the goal in these patients is to eradicate the prostatic infection as well as the bladder infection.
Antibiotic therapy is tailored to urine culture results and is be continued for 2–4 weeks.Otherwise UTI tends to recur.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Hello Sir,
I have had 3-4 bad UTIs in my life. But each cleared if the culture report helped out doc. and i took the medicine prescribed by him.One of the worst episode was cleared by -'Furadantin'. Then after few years anotherinfection i was put on Bactrim DS . Last time USG was also done at apollo gleneagles and Urine test for TB (24 hours) was asl0 done at Dr. tribedi and XXXXXXX which was negative each time.
The Usg test of kidney and bladder did not report any stones and what i remember kidneys was normal shape n size and texture.But there was incomplete voiding reported which my doc said was due to my neurological problem.WHich i think is chronic and cant b corrected soon.Dr. XXXXXXX dasgupta (neurologist) had seen me in abt 1996 and ruled out operating the spine.Only if conditions got worse he said we can for for surgery.MRI of the spine also didnt reveal any significant things or growth.So what is your opinion shud i continued with niftas some more time or do a fresh culture. As the cause incompleted voiding is difficult to cure.
Thanks.
A XXXXXXX
I have had 3-4 bad UTIs in my life. But each cleared if the culture report helped out doc. and i took the medicine prescribed by him.One of the worst episode was cleared by -'Furadantin'. Then after few years anotherinfection i was put on Bactrim DS . Last time USG was also done at apollo gleneagles and Urine test for TB (24 hours) was asl0 done at Dr. tribedi and XXXXXXX which was negative each time.
The Usg test of kidney and bladder did not report any stones and what i remember kidneys was normal shape n size and texture.But there was incomplete voiding reported which my doc said was due to my neurological problem.WHich i think is chronic and cant b corrected soon.Dr. XXXXXXX dasgupta (neurologist) had seen me in abt 1996 and ruled out operating the spine.Only if conditions got worse he said we can for for surgery.MRI of the spine also didnt reveal any significant things or growth.So what is your opinion shud i continued with niftas some more time or do a fresh culture. As the cause incompleted voiding is difficult to cure.
Thanks.
A XXXXXXX
Brief Answer:
Recurrent UTI
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
In view of recurrent urinary tract infection,you need to undergo fresh urine culture and continue with Niftas (nitrofurantoin) till culture report is available.
However resistance to nitrofurantoin is low.
What is your post void residual urine (PVR) on USG.If it is more than 50 ml ,it is considered significant.
Another future alternative is to send a midstream sample of urine for culture and self-administer treatment with a course of antibiotics as soon as symptoms start and to consult doctor with culture report . This 'Patient-initiated therapy' is better than low dose daily antibiotic prophylaxis say Nitrofurantoin 100 mg daily at night for 6 months ,to avoid recurrent UTI.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Recurrent UTI
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
In view of recurrent urinary tract infection,you need to undergo fresh urine culture and continue with Niftas (nitrofurantoin) till culture report is available.
However resistance to nitrofurantoin is low.
What is your post void residual urine (PVR) on USG.If it is more than 50 ml ,it is considered significant.
Another future alternative is to send a midstream sample of urine for culture and self-administer treatment with a course of antibiotics as soon as symptoms start and to consult doctor with culture report . This 'Patient-initiated therapy' is better than low dose daily antibiotic prophylaxis say Nitrofurantoin 100 mg daily at night for 6 months ,to avoid recurrent UTI.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello,
Thanks for your valuable advice.I will get a fresh culture done soon.Forgot to upload reports at first step.The Post void urine in USG of KUB says volume is significant 102ml. It also says ureters r not dilated.No mass is seen etc.So meanwhile as u said i continue with niftas 100 SR for 14 days.If again i have these problem i wll get back to this site with the report scanned.
Also shall i take Niftas 50mg twice daily, or 100 mg once daily?I have no fever or nausea now.But frequency of urinate increases somtimes.Have to get up 3-4 times at night.Normally 2-3 months back i had to get up once only.
Regards XXXXXXX XXXXXXX
Is there any advesre side effect of Niftas( Nitrofurantoin).Some times i can feel the heart beating and bit tightness in chest while taking this medicine,not whole day and heart rate is within 75-80.
Thanks for your valuable advice.I will get a fresh culture done soon.Forgot to upload reports at first step.The Post void urine in USG of KUB says volume is significant 102ml. It also says ureters r not dilated.No mass is seen etc.So meanwhile as u said i continue with niftas 100 SR for 14 days.If again i have these problem i wll get back to this site with the report scanned.
Also shall i take Niftas 50mg twice daily, or 100 mg once daily?I have no fever or nausea now.But frequency of urinate increases somtimes.Have to get up 3-4 times at night.Normally 2-3 months back i had to get up once only.
Regards XXXXXXX XXXXXXX
Is there any advesre side effect of Niftas( Nitrofurantoin).Some times i can feel the heart beating and bit tightness in chest while taking this medicine,not whole day and heart rate is within 75-80.
Brief Answer:
Nitrofurantoin -dose & side effects.
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The dose of Nitrofurantoin (Niftas), is 100 mg bid i.e. twice daily for 5-7 days and Long-Term Suppressive Therapy-adults: PO 50 to 100 mg at bedtime.
Since you have already completed 10 days course of Niftas 100 mg twice daily ,You can take now 100 mg once daily preferably at bedtime.
Common Side Effects of Nitrofurantoin- Nausea, headache .There is no cardiovascular side effects as you described.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Nitrofurantoin -dose & side effects.
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
The dose of Nitrofurantoin (Niftas), is 100 mg bid i.e. twice daily for 5-7 days and Long-Term Suppressive Therapy-adults: PO 50 to 100 mg at bedtime.
Since you have already completed 10 days course of Niftas 100 mg twice daily ,You can take now 100 mg once daily preferably at bedtime.
Common Side Effects of Nitrofurantoin- Nausea, headache .There is no cardiovascular side effects as you described.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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
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