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Suggest treatment for recurrent urinary tract infection

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Posted on Tue, 15 Apr 2014
Question: I have lymes disease and have been on high dose antibiotics for 5 mths. I have developed a pseudomonas aeruginosa infection of my bladder x2 in a period of of 21/2 mths. my 3rd ua has showed this again.i,m also taking fleuconazole p.o. 100mg daily. any hope for this problem?
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Answered by Dr. Ivo Ditah (5 hours later)
Brief Answer: Yes, there is hope.... See below Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this recurrent urinary tract infection. It is rather unfortunate that this keeps showing up. I will like to know if the pseudomonas showed any resistance to the antibiotics on the culture and sensitivity testing of your u/a. Or, is this simply a recurrent infection after being completely treated and symptom free from the previous infection. If it is because you keep getting infected again with the same germ, then I will suggest that the doctors look for what the various factors promoting this constant reinfection or difficulty sterilizing the urine. If antibiotic sensitivity is not done, they should do it to tell what the exact antibiotic that would be able to help sterilize this infectious site would be. In all, let the doctors check and make sure the antibiotics are able to act on this germ. If they are, they should try and look for contributing factors like urinary stone, incomplete bladder emptying, etc and also consider treating you for a longer duration using another sensitive antibiotic. At worse, they should consider putting you on prophylactic antibiotics if every other measure fails. I hope this helps. I wish you well. Thanks for using our services and feel free to ask for more information and clarification if need be. Dr. Ivo, MD.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ivo Ditah (11 hours later)
on XXXXXXX 29 I was treated with cipro 500mg o.d x 7 days. a previous rx of nitrofurantoin 100mg bid was only 40% effective ( symptom wise) so was changed to the cipro. I was reasonably well until march 3 when I came up with same diagnosis and went on cipro 500mg bid x 10 days.a follow up ua on march 26 shows the same thing. don't know what the concentration of bacteria is yet.odd since the c&s shows both drugs to be sensitive. I have been seeing a naturopath because no one here recognizes lymes . who should I be seeing to take care of this ua problem?
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Answered by Dr. Ivo Ditah (9 hours later)
Brief Answer: see a urologist or nephrologist Detailed Answer: Hi and thanks for following up with me. Because the culture results consistently show the same germ despite it being sensitive to prescribed antibiotics, the possibility of a contributing local factor is huge here. This has provided a constant source of reinfection that cannot be easily eradicated through the use of antibiotics. I will suggest you get consulted by a urologist or nephrologist and get the entire anatomy of the urinary tract evaluated through imaging studies to look for possible obstructions and other contributing factors like stenosis. Lyme disease can be treated with antibiotics. Have you tried any without success or why are you seeing a naturopath for this? I wish you well. Feel free to ask for information if need be. Thanks. Dr. Ivo, MD.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Ivo Ditah (24 hours later)
I am being treated by the same naturopath because I cannot find an m.d. who will recognize or has the expertise to treat lymes. this same naturopath had me on doxycycline 200 mg bid x 2 mths oct 5-dec 5.then clarithromycin 500mg bid&cefdinir 300mg bid & finally flagyl 500 mg tid added in a pulse method. I completed 6 cycles of flagyl until march 3. when the 2nd uti showed up, I stopped all other antibiotics to treat using cipro 500mg bid x 10 days. I,m assuming that I developed this pseudomonis bacteria from using these intensive antibiotics.????I,m still being followed by the same naturopath..my lymes symptoms have disappeared for the time being.since I am 72 and have medicare only, I will no doubt have to tell my regular medical provider( a d.o.) sooner than later.
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Answered by Dr. Ivo Ditah (2 hours later)
Brief Answer: Happy your symptoms have subsided! Detailed Answer: Hi and thank you so much for this follow up information. I am very happy to hear your Lyme's disease symptoms have subsided. It would make a great idea telling your regular doctor about this recurrent urinary tract infection called be Pseudomonas so that he can look into this and get the condition addressed in its entirety. True, extensive and broad spectrum antibiotics can open the door to more resistant strains and may be the case with you. Keep me updated with the progress of your treatment. Thanks and wish you well. Dr. Ivo, MD.
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Ivo Ditah

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Practicing since :2002

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Suggest treatment for recurrent urinary tract infection

Brief Answer: Yes, there is hope.... See below Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about this recurrent urinary tract infection. It is rather unfortunate that this keeps showing up. I will like to know if the pseudomonas showed any resistance to the antibiotics on the culture and sensitivity testing of your u/a. Or, is this simply a recurrent infection after being completely treated and symptom free from the previous infection. If it is because you keep getting infected again with the same germ, then I will suggest that the doctors look for what the various factors promoting this constant reinfection or difficulty sterilizing the urine. If antibiotic sensitivity is not done, they should do it to tell what the exact antibiotic that would be able to help sterilize this infectious site would be. In all, let the doctors check and make sure the antibiotics are able to act on this germ. If they are, they should try and look for contributing factors like urinary stone, incomplete bladder emptying, etc and also consider treating you for a longer duration using another sensitive antibiotic. At worse, they should consider putting you on prophylactic antibiotics if every other measure fails. I hope this helps. I wish you well. Thanks for using our services and feel free to ask for more information and clarification if need be. Dr. Ivo, MD.