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Pseudomonas aeruginosa treated. Urine culture showed klebsiella pneumonia. Stopped magnex forte due to weakness. How to eliminate infection?

The patient has a neurogenic bladder due to a spinal cord injury (5 years back), she s on indwelling catheter since. A month back The patient was diagnosed with pseudomonas aeruginosa infection after heavy fever and was admitted for 5 days. She was treated with Magnex Forte and paracetamol. At the time of discharge the fever and infection went away and Magnex forte 3g (twice daily) was recommended for 14 days. After 14 days, urine culture was repeated again and multi drug resistant klebsiella pneumoniae infection is identified. The bacteria was only sensitive to colistin and tigecycline. However, the patient is asymptomatic(no fever,chills). The doctor recommended colistin (3 million iu twice daily) with Magenx forte (3g twice daily). After first day of dosage, the patient felt weakness with mild headache and difficulty to move due to muscle pain. When asked, the doctor said this is unusual and instructed to stop the medication. Is the symptoms of weakness normal looking at the dosage? Is there any recommended medication for the weakness ? Is is ok to stop the medication prematurely ? If we stop the medication what s the next step to eliminate the infection ?
Asked On : Tue, 15 Oct 2013
Answers:  1 Views:  141
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Internal Medicine Specialist 's  Response
Thanks for using Healthcaremagic,

After going through available details, yes it is challenge to treat multidrug resistant infection the organisms which are isolated both are notorious and sometime resistant to very good antibiotics.

In such cases urine culture and sensitivity is very useful to guide for therapy this is good that she responded to Magnex forte.

It is prudent to use intermittent catheter to empty bladder instead of indwelling catheter, This should be removed and send it's tip for culture to identify pathogenic organism. At least indwelling catheter should be changed periodically and siliconised one is better

If antibiotic used produces undesirable side effects we need to stop the treatment then alternative drug is to be used. Some time drug may be resistant in reports but works in patients.

Then we should keep good hygiene and hope for best.

Hope this information helps.

Take care
Good Luck.
Dr.AKhilesh Dubey M.D.
Answered: Fri, 22 Nov 2013
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