Start antibiotics for UTI before seeing doctor??

[gjnl]

I have the same understanding with my doctor as described by "hlh," with one difference that may be unique to my location. In my area, we have several independent (not associated with any clinical setting) testing laboratories where you can take your doctors order requisition for blood, stool and urine tests.

At annual physical time, I take a one time order to one of these labs. They draw and process the blood, and I bring a urine specimen with me to the lab for processing and testing. Results of all tests are forwarded to the doctor and sent to me at my home (California law allows patients to get results from laboratories upon request).

I have standing orders for monitoring prothrombin time (blood clotting) and non-Hodgkins lymphoma markers, urinanlysis, culture and sensitivity. A standing order is written by my doctor for a specific test to be performed at specific intervals, is on file with the lab, and good for one year from the date it is written. One of the labs in the area is associated with one of the local hospitals and with a standing order on file, I can drop a urine specimen off at the 24/7 hospital lab (don't urinary tract infections always occur during weekends and at night??? ).

My understanding with my doctor is to take a specimen to the lab for urinalysis (UA) and culture and sensitivity (C&S) under the standing order before I take antibiotics. I have Macrobid on hand, which my physician feels will knock down symptoms enough to keep me comfortable until results are in and he can select the most appropriate antibiotic to use. This system has worked very well for me and my doctor. But, as "hlh" indicated, you need to establish a working, trusting relationship with the physician for this arrangement to be effective.

All the best,
GJ

[SCI-Nurse]

thanks gjnl for that posting on that study. The other thing to remember is that urine culture & sensitivity bacterial growth will be treated for bacterial growth >100,000; not usually for anything less.

pbr

[Sue Pendleton]

Arndog, the 250mg of Cipro was for a test precaution. IOWs, it seems rather the common thing to prescribe Cipro before testing. He's getting symptoms then start Cipro but at the strength, preferable, for killing it 500-750mg twice a day until he sees a doc. I'll be talking to my new uro about a standing order that then goes to my primary to prescribe anything 500mg of Cipro BID won't kill based on the C and S because she doesn't feel comfortable not seeing me first. It's been about 100 degrees here for 2 weeks and my transfers die at about 90.

[quadmarie]

I took a urine sample and to my urology clinic yesterday and the nurse called me and told me my urine looks really good and she could not see much under the microscope. She told me to continue to drink more and call her back if I'm still having symptoms. I told her I drank a whole lot before I gave her the sample so it was very diluted. I asked her to still culture it because I have asked on here and was told that even clear diluted urine can show positive for a UTI. It just bugs me that she was not going to culture for me. I have some Bactrim but I do not like taking antibiotics without knowing what kind of bug I may have.

[gjnl]

Originally Posted by Sue Pendleton

Arndog, the 250mg of Cipro was for a test precaution. IOWs, it seems rather the common thing to prescribe Cipro before testing. He's getting symptoms then start Cipro but at the strength, preferable, for killing it 500-750mg twice a day until he sees a doc. I'll be talking to my new uro about a standing order that then goes to my primary to prescribe anything 500mg of Cipro BID won't kill based on the C and S because she doesn't feel comfortable not seeing me first. It's been about 100 degrees here for 2 weeks and my transfers die at about 90.

I have had my arrangement (urinary tract infection symptoms, get a specimen to the lab, then start Macrobid 100mg twice a day until results come in from the culture and sensitivity) with 3 different physicians over the years. All of them have preferred Macrobid during that waiting period because they want to reserve Cipro (a broader spectrum antibiotic-what they have termed "the big gun") for the really tough bacteria. That said, there has been a time or two when the Macrobid didn't knock the edge off of the symptoms before the results came back and they have advised to change to Cipro 500mg twice a day until we see the results of the culture and sensitivity.

All the best,
GJ

[Sue Pendleton]

GJ, Way back Macrobid or Macrodantin was also the first line. It never worked. I seem to be a Cipro normally with occasional bouts of Augmentin thrown in type of gal. We also had a great system of dropping a sample off and I would try not to hit the antibiotics at home until the C and S was back. With IBS antibiotics are not my favorite drugs especially the old Cephalaporin types. I actually had great success stopping this one cold with diet cranberry juice. Hopefully it will stay that way until I have a pre-op physical the 19th.