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Thread: When do you decide to take an antibiotic for a UTI?

  1. #1

    When do you decide to take an antibiotic for a UTI?

    For the first six years after my injury, I was very blessed with regards to avoiding UTIs. In the last year I've been treated for two, and I have recently been feeling like another one is coming on. I went into the doc today, and he's doing a urinalysis and culture. The urinalysis has already come back as "strongly positive", but we are waiting on the results of the culture to decide what antibiotic would be best.

    I have a SP catheter. I've always been under the impression that you should treat the symptoms, not lab results, when it comes to dealing with UTIs and indwelling catheters. My doctor is just a regular doctor on campus and has no quadriplegic experience. On one hand I have been seen more sediment in my year in and have noticed an odor occasionally. The last two days I have been feeling kind of crummy, but this morning I finally woke up feeling pretty good.

    The results of the culture will be back in two days and I'll have a suggestion for an antibiotic to take. How long would you try to flush it out naturally (with lots of water, cranberry juice, etc.) before you decide to take an antibiotic? I'm not a fan of taking unnecessary antibiotics.

  2. #2
    Senior Member
    Join Date
    Jan 2009
    I take macrobid (nitrofurantin) 100 mg twice a day to prevent UTIs. Whenever I'm off of it I get a UTI. Then again that's life, one uti after another at least for me. It's gotten worse the longer I've been injured and I know eventually I'll become antibiotic resistant but for now IV vancomyacin does the trick when I need it. Good luck! I'd pound the fluids, just drink water, water, and more water. I took cranberry extract for an entire year and actually got more UTIs then so now I don't bother with it.

  3. #3
    Senior Member fishin'guy's Avatar
    Join Date
    Jun 2008
    Seattle area Wash state
    Not sure when,But don't do like I did, waited,didn't know, or what ever, Temp hit 104 and had a pain in my thigh that didn't go away with dilaudid, 3X. Went to outcare and they put me in the hosp for 3 days, sheesh, for a uti? did have some other issues but my gawd. Guess it can get dangerous, go before then and get antibiotics.

  4. #4
    Senior Member
    Join Date
    Aug 2010
    Oregon usa
    For me one of the signs I have one and need to treat it is I will pee out my penis even if the SP is clear . I just got done with treating one and did a UA after and its still there, I think I'm just going to watch how I'm feeling and treat it then. It's funny but every medical professional I have talked to about UTI's and a SP feels the need to tell me that I will always have UTI's with a SP, like I hadn't heard that before.I do worry about the infection moving up to my kidneys. If you do treat it try to get 10 days worth.
    c3/c4, injured 2007

  5. #5
    i know i have a bladder infection that needs to be treated when my bladder is sore and i can feel the catheter inside, poking me. i get the chills, too and feel lousy overall.

    "All that is necessary for the triumph of evil is that good men do nothing" ~ edmund burker

    c4-5 quad

  6. #6
    Fever along with chills, when the white blood cell count is elevated in the blood, not necessarily the urine.
    And the truth shall set you free.

  7. #7
    You may not want to wait for fever and chills,
    increased spasms- bladder spasms or leg spasms, fatigue, not feeling well, are symptoms that warrant treatment,

  8. #8
    As per a earlier thread I read here, I have been flushing my bladder via Mitrofanoff with 50 cc of Microcyn, followed by saline, when I know that i have a uti. It has worked 3 times in the last 9 - 10 months. If it doesn't work, I will see my urologist, as the cause of many past uti's has been kidney and bladder stones.
    Karen M
    C 3/4 inc. central cord
    10/29/1992 - 18 years, but who counts?

  9. #9
    Senior Member
    Join Date
    Jul 2009
    Alberta, Canada
    My specialist in the Glenrose hospital is adamant that you do not take antibiotics until they have the results on the culture. Once you know what antibiotic the bug is sensitive too then you treat it. otherwise you might end up having the UTI twice as long as it doesn't get treated/killed and ends up coming back. You should NEVER take antibiotics unnecessarily, your body and bugs will build up a tolerance over time.
    I know it sucks waiting, as i tend to have bladder accidents a lot when I have a UTI.......I got tired of waiting so long that when it happens to fall on the weekend when the incubation time is completed I was able to get the actual phone number to the lab so I can get my own results back. My family doctor has a prescription for 3 different antibiotics that covers the gambit for me to keep on file with my Pharmacist. So when I get the sensitivities info from the lab I match it up with proper antibiotics (under the supervision of my Pharmacist) this way I am able to start the antibiotics sooner than having to wait all weekend. During the week days my doctor just phones me with the results he gets back from the lab and I match it up with the proper antibiotics, or he will tell me which one to get. Saves me more time not having to try to make a doctor appointment to get the proper antibiotics, and for some people it takes a week or more to get in to see their doctor.


  10. #10
    Nearly always, it is recommended that you NOT treat just because you have a positive culture without serious symptoms (such as fever, chills, bad spasticity increase, significant leaking, elevated white blood count in your blood, blood in your urine, etc.). Cloudy or smelly urine, or sediment in your urine is not sufficient. This is considered colonization, not an infection, and esp. in those with a neurogenic bladder and a long term indwelling catheter, would not be an indication to take antibiotics.

    If you do have the symptoms above, then a urine culture & sensitivity should be collected. An antibiotic can then be started (if prescribed for you) but it is CRITICAL that the culture and sensitivity (C&S) resulted be checked at 72 hours. If you are on the wrong antibiotic, it must be changed. Also, in people with SCI, any real UTI like this should be treated as a complex UTI, requiring 10-14 days of antibiotics to treat (not the 5-7 days used in ABs).

    While this is an older reference to share with your physician, it is still considered the standard of care by expert SCI physicians and urologists:


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