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Thread: UTI & Antibiotic Question

  1. #1

    UTI & Antibiotic Question

    The last several months I've been battling recurrent UTIs. I finished a 10-day course of Macrobid and Tetracycline and went for a follow-up appointment on Tuesday. The nasty smell and particles in my urine were clear, and I don't have a fever. They took a urine sample and said it tested positive for infection, so the doctor ordered 7 days of IV antibiotics (Invanz). The nurse called me this morning and said the culture came back negative, but they want me to continue the outpatient IV antibiotics once a day (I've had 2 days, with 5 days to go). I still feel icky, but should I be continuing to get IV antibiotics if the culture came back negative? Besides being a hassle of getting to the hospital every day, I'm worried about getting antibiotics and the possible side effects. It has been over 13 years, but I had a few bouts of the dreaded clostridium difficile (c diff) when I was in rehab at Craig. Should I stop the IV antibiotics? Thanks.

  2. #2
    Are you running a fever as well? They say do not treat unless you have fever and other symptoms.

  3. #3
    I do not know why they started the antibiotics before the culture-sensitivity came back, especially when you did not have a fever. Bad practice there. Now you are in a bind. Stopping early is the main contributor to resistant bacteria strains.
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  4. #4
    Hi Mike,
    As "SCIfor55yrs" says you are in a bind...taking short courses of antibiotics can contribute to developing resistance to specific antibiotics, and courses of antibiotics, especially IV, can put you at risk for a recurrence of C.diff. Rock and a hard spot. That said, in 33 years post injury, I have had a couple urine cultures that came back no bacteria, when indeed there was bacteria present (false negative), and treating with an antibiotic was appropriate. I am also someone who never has a fever with an over 100,000 CFU (culture forming units) of bacteria urinary tract infection. I do have the worst autonomia symptoms ever, that can last for several hours and sometimes have to be treated with medications to bring my severely elevated blood pressure down to a safe range.

    It is possible that the nurse meant that the bacteria was present, but there were not sufficient CFU concentrations to normally indicated treatment, but given your symptoms, treatment of complicated urinary tract infections (all spinal cord injury related urinary tract infections are complicated) warranted antibiotic administration. The annoying part of your story is that the urologist would prescribe any antibiotic without first having the results of a culture and sensitivity (C&S). It is time to have a discussion with your provider about appropriately prescribing antibiotics, i.e., Symptoms ➞ Urinalysis (UA) ➞ Culture & Sensitivity (C&S) ➞ Antibiotic most appropriate given results of the C&S.

  5. #5
    I am not trained to advise on this, but I would not stop taking Invanz until you complete the cycle or told so by a specialist. That is one of the heavyweight antibiotics, you dont want to mess with invanz resistant bacteria.
    T6 complete (or so I think), SCI since September 21, 2003

  6. #6
    I would call and get clarified. You had 2 culutres- one they started the abx on and the second after takiing by mouth and when he started IV? I would call the doctor and clarify but I don't think 2 days more is going to hurt.

  7. #7
    I am also currently battling a UTI and from what I read here I made some mistakes that also puts me in the 'bind' category. A doc gave me macrobid to have on hand if I ever see symptoms and I stupidly started it on Sunday eve when I noticed I had a UTI instead of going to have it cultured. It was late at night when I was sure no natural methods would turn things around so I took the lazy way out knowing by the time I get through ER it would be 6 hours later before they finally gave me something...and whatever the gave me would be guess since they won't have a culture to go by either. Now I realize that I shouldn't let them give me anything until the culture comes back if I can last that long! I was septic the last time a tried to cure a UTI naturally and they kept me in the hospital for a week.

    Anyway, I went back to the walk in clinic that gave me the macrobid and I saw a different doc this time that said macrobid is best for prevention and suggested Cipro as the best to actually kill bacteria. I have used Cipro in the past and it was always the AB I responded best to, so I agreed. Well, Cipro didn't do much so I went to ER and they sent me home to continue with Cipro. They checked my kidneys etc to make sure I had no other issues (stones etc) and i'm clean but i'm still not getting good results from Cipro...urine still dark and cloudy and frequent dribbling.

    Should I try and stay on Cipro? They took a urine sample to culture but they said the count was really low so i'm not sure if they'll get a positive culture anyway and I won't know for another 2 days.

    I think i'm in a bind and I've already committed a couple violations.
    Is it ok to try to flush with veterycin to help Cipro with the job of killing the bugs in the meantime?
    Last edited by crispy1981; 01-20-2015 at 09:51 PM. Reason: correct grammar

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