Recommended course of action is given below
Thanks for your query.
There are several causes of recurrent UTI, such as:-
# an abscess in the kidneys,
# stone(s) in the kidneys or urinary bladder
# a growth in the bladder,
# a distant infection spread to the kidneys through the blood,
# contamination of urine pipe opening by anal bacteria or
# transmission of chronic vaginal infection
(bacterial, yeast, trichomoni or chlamydia) into the urine pipe opening;
# other structural causes, such as, a fistula (abnormal connection between rectum and bladder; between vagina and bladder.
Further, an underlying undiagnosed diabetes
too predisposes to frequent UTI
Other possibilities are, inadequate duration of treatment of UTI; use of an antibiotic which is resistant to the offending bacteria; or, fungal (yeast) infection which is not treatable by antibiotics but by an anti-fungal drug.
Ideally, whenever UTI occurs, urine examination + culture and sensitivity test should be carried out to firstly, isolate the causative organism (bacteria or yeast) and secondly, to short-list the antibiotics/antimicrobials which are most lethal to the offending bacteria.
Use of one of the most effective antibiotic FOR AN ADEQUATE DURATION (ideally, until no bacteria are grown on urine culture) IS THE MOST EFFECTIVE METHOD OF COMPLETELY ERADICATING THE INFECTION. Partially treated UTI or use of ineffective antibiotic always leads to frequent recurrences of UTI.
If yeast is isolated in the urine, an anti-fungal drug, such as, Fluconazole
is the drug of choice.
Hence, I would recommend that:-
* Blood sugar test be done to exclude diabetes
of kidneys and bladder to rule out abscess/stones/growth
* Gynecological examination to rule out structural defects, such as, fistulas as described above
* All relevant investigations to be carried out to rule out/diagnose the likeliest cause of recurrent UTI, as described above
* Lastly, in case of subsequent UTI, insist on getting urine examination + urine culture and sensitivity test done, so that the most sensitive antibiotic is prescribed by your doctor.
As far as your C.diff infection is concerned, if it has not improved with flagyl, oral vancomycin
powder, 125mg every 6 hours for 2-4 weeks, should cure the infection.
Consult your doctor and apprise him of my opinion. I am certain that he will agree with my opinion; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised.
Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any.
Fond regards and have a nice day,
Dr. Rakesh Karanwal