Question: I am asking Dr XXXXXXX only to answer as he has some of the background knowledge
I am reposting the whole mid Dec epilogue below and questions below
Dec 13 - Mild bladder symptoms - Urine sample taken with culture
showing > 100 * E6 cfu/L and sensitivity to fosfomycin and
nitrofuran, lab urinalysis showing already 0.3 mg/L ethrocytes
Bladder symptoms resolve within a couple of days

Dec 18 -Home urinalysis strips showing 200 RBC's,
nitrites/wbcs positive - brown urine
Fosfomycin 3grams given, xarelto 15mg stopped

Dec 21 -Nitrites and rbcs negative, xarelto resumed after 3 days

Dec 23 -Nitrites/leukcocytes positive, rbcs negative
Urine culture shows same high ecoli count and sensitivity
to fosfomycin/nitrofuran later on

Dec 25 -RBC >200, strong pink urine tinge, Nitrofuran 200mg daily started for 10 days
Xarelto stopped again

Dec 28 - RBCs, Nitrites, WBCs - Negative, Xarelto resumed

Dec 29 Nitrites/WBCs - negative, BROWN cloudy urine - RBC's 200 plus
STOP xarelto again

Dec 30, Dec 31st, XXXXXXX 1st - Urinalysis negative for all parameters

So Dr XXXXXXX as you can see, the nitro appears to have helped with the ecoli
and I stopped again the xarelto for 3 days after the nitro was given.
But when I began the xarelto after 3 day stop - she had 200 rbcs in the urine sample the following morning. It was taken at night.

So since mid Dec - she has been on and off three times - totalling each time
3 days, 3 days and as of tonight 4 days.

You had made the statement not to put over concern over stopping it for even a weeks time.

I was not able to post recently on this site.....and others have stated stay off it for 3, 5, 7 days in succession. However a cardiologist has stated urinary bleeding is not much of concern to grave danger for cardiac risk.

The general doctor isnt back til Tuesday, and the local uro clinic doesnt have an interest here either

What are your thoughts.... I was going to put her back on the xarelto either tomorrow or Tuesday but I am not a doctor and cannot guage the validity of website advice either - thanks

My mother refuses to go to an ER or Urgent Care Clinic.
We have waited two times in the last year 5 to 7 hours to see a resident.
They wont have the technical capacity to provide a adequate answer.

Her cardiologist isn't back til XXXXXXX 9th.
The uro clinic doesn't need blood loss an emergency and her family doctor is back on Tuesday. He provided the nitro but did not believe the blood thinner to be a problem. The last week showed otherwise - nitrites and wbcs negative and she bled again after 1 day of beginning the xarelto.

I was going to start her tomorrow night - but that would only be 4 days off - you are inferring 7.

I feel super paranoid about this whole situation.
So if I start in the next three days - whether tomorrow, Tuesday or Wednesday - if she does bleed again - then what.
She will definitely need an ongoing antibiotic after the nitro is done or there will be no finish to this....
I regret deeply now that as soon as nitrites was discovered on Dec 13th - fosfomycin should have been provided.

My mother and I saw the family doctor today - I printed off some of your opinion and stated this comes all the way from XXXXXXX from an experienced uro.

He cited that he has never come across an acute bleeding episode with an ecoli bladder uti when a blood thinner was being used. Her urine was only pink/brown tinged (Not red) and no acute pain
He examined my mother to not having any signs of current atrial fib but still hammered upon that 5 days should be the XXXXXXX off the grand xarelto

He wants to take a blood sample to see if any true blood loss has occurred.

Upon asking - what could be done if tinged urine was found tomorrow - he had no meaningful response. He thinks it will resolve on its own...

I have encouraged my mother - two extra days wont put her in peril danger but a son does not have the validity of a medical doctor.
She sits now belaboured at the dinner table as the doctor put angst into her citing he had a patient that just had a stroke because he went off the blood thinner.

Goodnght

My mother didn't take the xarelto for 6 days.
Within a day of taking the xarelto again - rbcs were negative.

She was on 200mg macrobid for 10 days
The last two nights, it was only 100mg as a preventative.
She has incurred the last two mornings -diarrhea (not bloody) - just loose but she wasn't able to hold it and a accident incurred.

Does one hold off it for a few days.
Is Macrodanten not better than Macrobid?

I still have fosfomycin sachets. Resistance is low for that.
If she were to develop a new ecoli, could it be be used to treat early or should one go back to the nitro eventually