Another UTI: This time I'm resistant to Macrobid and Cipro...

[Theophania]

...so they put me on Nitrofurantn.

I'm scared. What if nothing works on me?? How many more UTI antibiotics exist before I'm resistant to everything? Anyone know?

I'm thinking I'm going to use a new catheter everytime I pee from now on. I am too scared I'm going to die young

[Jadis]

which bug do you have? Make sure you are taking them right... 3x a day means every 8 hrs, not 3x while you are awake. Once a day SR antibiotics need to be taken at the same time every day.

Are you taking the Nitrofurantoin two or 4 times a day?

[Le Type Français]

Theo,

Your resistance only means the bacteria affecting you now is resistant, not that Cipro will never work for you again.

Hope this helps.

Todd

[lynnifer]

I want to say prevention is the way to avoid this ... but I'd sound like a hypocrite since I don't cath.

[SCI-Nurse]

Well, now I am confused. Macrobid IS Nitrofurantoin, so it sounds like you are on an antibiotic that will not be effective for you. Have you been taking routine Microbid? This would explain the resistance you have developed. Microbid is technically a urinary antiseptic, not an antibiotic, and is rarely effective for resistant bacteria anyway.

What did your sensitivity show as the BEST antibiotic for this bug? When you say infection, are you talking about a positive culture, or do you also have a fever/chills, severe spasms, malaise, AD, flank pain, etc?

(KLD)

[Wise Young]

Originally Posted by Theophania

...so they put me on Nitrofurantn.

I'm scared. What if nothing works on me?? How many more UTI antibiotics exist before I'm resistant to everything? Anyone know?

I'm thinking I'm going to use a new catheter everytime I pee from now on. I am too scared I'm going to die young

Theophania, what you ask is a nightmare for many physicians. People usually classify antibiotics by their mechanisms of action (e.g. penicillins, cephalosporins, fluoroquinalones, tetracyclines, macrolides, aminoglycosides) but bacteria showed their verstility when they not began to develop resistance to multiple antibiotics at a time but were able to transfer the genes for multiple resistance in one fell swoop (Source). So, now, doctors are beginning to classify antibiotics by their action on different bacteria Source).

The problem is that bacteria will develop resistance to any antibiotic, if we expose enough bacteria to the antibiotic. Class III antibiotics are those that require physicians to consult with an advisory source before prescription (Source). These are antibiotics that should be sparingly used and only when necessary, so that we do not breed resistant bacteria.

The way that I think we should use antibiotics is what I call a "sucker punch" approach. You first lead with a Class I broad spectrum antibiotic to winnows down the herd to a few bacteria and then hit them with a Class II and Class III drug to deliver the knock out punch. The worst thing to do is to keep hitting with a Class III antibiotic and have nothing left to punch with when the bacteria learns how to defend itself.

Very unfortunately, farmers have been using potent antibiotics for decades in feed. For example, chicken farmers use an fluoroquinolone antibiotic called Baytril in chicken feed because they found that this increases the average weight of their chicken. In doing so, they have created bacteria that are resistant to most fluoroquinolones, including Cipro. Doctors also have been guilty of leading off with Cipro as the first antibiotic of choice to treat bladder infections. In doing so, they are limiting the usefulness of Cipro, and the reason why it is not working for many people.

Some 25-30% of bacteria are turning out to be resistant to common antibiotics. Many scientists are alarmed by the decreasing discovery rat of new antibiotics. As opposed to a decade or two ago, when multiple antibiotics were being discovered every year, few new classes of antibiotics are being discovered. One new one that was discovered recently is a peptide discovered in the fungus found on Northern European pine trees (Source).

Many clinicians now have begun to use a method called antibiotic cycling, i.e. giving different classes of antibiotics for varying lengths of time. Some have begun to cycle multiple "cassettes" of antibiotics (Source). Some clinical trials have suggested that this approach is more useful than others.

Wise.

[Le Type Français]

Dr. Young,

That is interesting you mention that. My urologist always prescribed Cipro as the first defense. Another doctor a little over two weeks ago gave me Cipro ear drops to fight an infection.

[SCI-Nurse]

Cipro is the poster child for overused, overprescribed antibiotics. Too many physicians just prescribe it for everything without getting cultures and sensitivities, and using older, just as good antibiotics appropriately. This has resulted in MANY stains of Cipro resistant bacteria in hospitals and in the community....it explains nearly all of the MRSA we see today.

Here is a timely article from today's NY Times:

http://query.nytimes.com/gst/fullpag...53C1A9679C8B63

(KLD)

[sjean423]

Originally Posted by SCI-Nurse

Cipro is the poster child for overused, overprescribed antibiotics. Too many physicians just prescribe it for everything without getting cultures and sensitivities, and using older, just as good antibiotics appropriately. This has resulted in MANY stains of Cipro resistant bacteria in hospitals and in the community....it explains nearly all of the MRSA we see today.

(KLD)

I am changing urologists for exactly this reason. My last UTI she took 2 days to return my call, and was going to prescribe Cipro without any lab work. In the meantime I got fed up (and sicker) and called my GP, who ordered lab work (and in the end I took Cipro anyway, because the Bactrim gave me hives, but at least we knew it was the correct action). I don't have a lot of faith in this urologist anymore.

[paramoto]

My doctor prescribes Nitrofurantoin a lot. He also has prescribed antibiotics without a culture/sensitivity test, which I now totally refuse. I don't have access to too many other urologists where I live. I have had high leucocytes (15-20) and colonization for around four weeks now, started developing a little fever last week and took Nitrofurantoin twice a day and now my leucocytes are down to 2-4, which is low/normal for me and no colonization was detected. I know self medication is really bad, but I started with what I understand is the lowest possible antibiotic and it worked, instead of cypro which is what my doctor prescribed for me to take one month ago (the bacteria showed to be sensitive to Cypro in the sensitivity test I did at that time).