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Thread: Antibiotic resistant UTI

  1. #1

    Antibiotic resistant UTI

    I have been dealing with a recurrent UTI over the last several months. My GP was prescribing Cipro which did not seem to help. I made an appointment with a urologist and he prescribed nitrofurantoin, which was also ineffective. I finally was set up to receive an IV antibiotic (meropenem) twice a day for a seven day. Each IV lasted 30 minutes. Two weeks later, and I'm back where I started. I have an appointment next week with a new urologist who hopefully will have a better plan.

    I have a couple of questions. Should I try to find a urologist that specializes in patients with spinal cord injury? If so, does anyone know of a good one in either Syracuse or Albany New York?

    I live in a small town in upstate New York and my medical choices are very limited. I could go on and on with the frustrations I had with my original urologist and my previous GP, but it wouldn't do much good at this point. I did switch to a different healthcare system back in August to try and get better treatment, but there are really no urologists in the area with extensive spinal cord injury experience.

  2. #2
    Have you had tests for stones, strictures, or other problems such as this? You should have these annually and any time you have the same bug over and over.

    Finding a good neurourologist may not be easy. Try contacting local university medical centers for a referral as they are most likely to have that (such as SUNY).

    If the usual obvious causes have been ruled out, and you are having true UTIs (not just chronic colonization), then your GP and/or urologist should have you consult with an infectious disease physician.

    (KLD)

  3. #3
    I have had an ultrasound, x-ray, and a CT scan. There were no kidney stones but there was a small cyst on one of my kidneys.

  4. #4
    Did these studies include the bladder and ureters along with the kidneys?? Have you had a recent PSA? Chronic prostatitis can also cause these types of problems, and may be difficult to diagnosis in men with SCI. Your PSA level will usually be elevated in this case.

    (KLD)

  5. #5
    I completely sympathize with the challenges of finding a urologist. My Dad is on his 5th!! I agree that I would look at the closest universities/academic hospitals and look at each urologist. While you wont find someone specialized in SCI, look for one with an interest in "neurogenic bladder". Another suggestion is calling the best SCI Rehab centers in your part of the country (Sunnyview Rehabilitation Hospital in Schenectady, NY) and either going there once for an evaluation with urodynamics, or get a referral from them to the best local neuro-urologist.

    http://www.nehealth.com/Medical_Care...njury_Program/

    Are you always doing a culture before starting treatment? Are your doctors using the correct antibiotics for each infection?

    Are they treating for 2 weeks, since these infections are "complicated", and this is the recommended treatment?

    How do you manage your bladder? Have you had urodynamics lately? Are your pressures getting high? Are you on a medication to reduce your bladder pressures like sanctura?

    When my father had a UTI that kept coming back again and again and again (same bug) his urologist put him on antibiotics for 5 or 6 weeks. And that did it. Did he have prostatitis (which the nurse is correct about - it can be hard to diagnose in SCI folks and is a diagnosis of exclusion)? Who knows..... probably not. But his doctors agreed that sometimes a prolonged antibiotic course can break a bad cycle. But he made sure it was the correct antibiotic (Bactrim) for that bug.

    3 years later, my father got a series of 7 UTIs in a row, each one different, and each one more resistant. He had all the tests (CT/ultrasound/urodynamics etc..) and there was no clear new cause. His new urologist (very experienced with SCI) started him on Gentamicin antibiotic bladder instillations twice a day. And worked. Some of this urologist's patients do this for awhile (months? year?) and it breaks a bad cycle, and they stop. Some folks have to continue it long term.

    There are many other things folks do on this site for UTI prevention. Methanamine (plus vitamin C to acidify the bladder), D-mannose (if the UTIs are E coli), cranberry pills, drink drink drink, review your cath technique and start to use enclosed kits if needed, and microcyn/hydrocleanse bladder instillations.

  6. #6
    Dr elise de in albany specializes in neurourology she also has a collegue dr kit who is very good as well. They are both at the northeastern urological assoc of albany.

    here is their website

    https://www.communitycare.com/Practices/Urology/

    this is the same practice i go to they are all great i see dr fisher now as he is the one who did my ileal conduit after dr de recommended i have it done.
    Last edited by Smashms; 09-17-2015 at 11:34 AM. Reason: Add website
    T6 Incomplete due to a Spinal cord infarction July 2009

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