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What Does This Urine Culture Report Indicate?
Question: 68 year old female has acute UTI, culture returned with >100,000 CFU/ML Klebsiella pneumonia, moderate Hgb Ur, Moderate Lekocyte Esterase, and 5-10/hpf WBC ur. Resistant to ampicillin, gentamicin, and ampicillin/sulbactam. Susceptible to ciprofloxacin, cefepime, nitrofurantoin and trimeth/sulfa. Has history of HTN and dyslipidemia, needs no medications. Has mild dementia and is incontinent. Which medication would be best for this elderly person?
Brief Answer:
Bactrim DS plus nitrofurantoin would be better.
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. With UTI proved by urine culture report, and incontinence, bactrim DS is good option if no sulfa allergies in past. I would consider doule antibiotic therapy for better outcome as the UTI is likely the cause of incontinence as well and bactrim DS alone may not be enough. I usually recommend nitrofurantoin if there are no kidney functions decline. So she can be started on double antibiotic therapy if need be.
Along with that, bladder training, pelvic floor muscles exercises, use of some bladder relaxants as solifenacin etc, and hygiene maintenance step should be taken. Wait and see for the antibiotics to respond. She will be recovering soon from UTI and with that incontinence will also decrease.
I hope it helps. take good care of yourself and her and dont forget to close the discussion please.
Regards
Khan
Bactrim DS plus nitrofurantoin would be better.
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. With UTI proved by urine culture report, and incontinence, bactrim DS is good option if no sulfa allergies in past. I would consider doule antibiotic therapy for better outcome as the UTI is likely the cause of incontinence as well and bactrim DS alone may not be enough. I usually recommend nitrofurantoin if there are no kidney functions decline. So she can be started on double antibiotic therapy if need be.
Along with that, bladder training, pelvic floor muscles exercises, use of some bladder relaxants as solifenacin etc, and hygiene maintenance step should be taken. Wait and see for the antibiotics to respond. She will be recovering soon from UTI and with that incontinence will also decrease.
I hope it helps. take good care of yourself and her and dont forget to close the discussion please.
Regards
Khan
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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