Antibiotic-resistant UTI

[CapnGimp]

catheter candy

Went to do labwork today in preparation for surgery tomorrow. My urologist's office had 3 douette caths they had gotten by mail as samples for me. Went and picked them up and have them here at the hut for when I get out tomorrow. Unfortunately, he has me scheduled for an IV of levofloxacin, saw it on the paperwork. All the fluoroquinalones have always made me sick, temperature, weak, sore, etc. Over the first years of my sci, they gave them to me like candy for utis and that is what destroyed my shoulders, I'm sure. I'm HOPING to get back to handcycling asap, as this makes the pain a lot more bearable. We will see. Meantime, thankful to get the stones out and get another chance to stay colony free! I actually had to clean my silver coated cath last night about midnight, it was clogged and bladder distended again. I had JUST changed to it less than a week ago. Here is a pic of the 'crystals' that came out and off of it and the connector piece. Cleaned it out(rolled it between thumb and fingers, squeezing hard) for a few minutes, in a small black tub, like the ones ya get in a horsepital for bed baths. Bought at wal mart for a couple bucks.Suds on top, crystals piled up in bottom and a few small pieces scattered to the sides.

[CapnGimp]

D-mannose only works on e-coli. Prevents their cilia from getting a 'grip' on the bladder walls, essentially allowing them to flush straight out with the pee. It's a one-horse killer, like the so-called flu vaccines. Bactrim, like any other long term 'preventive use' antibiotic is not effective, and just allows build up of resistance to them. You KNOW your uro isn't knowledgeable if they go that route. You should get a uro to check for stones. I get 'pain' whenever I do a room temp flush, try heating it up to body temp by putting the container into hot tap water in the sink or something.

[Quad Marie]

Thank you

[Quad Marie]

Okay I do think I have a legitimate UTI because I am getting intense chills and my urine has gotten cloudy but I do not want to send it for a culture just yet. I am drinking more now and started taking d-man nose. I have been doing some reading about uroquid. Can someone tell me more about this and is this something I can get over the counter or do I need a prescription?

[SCI-Nurse]

Yes, it needs a prescription. The premise behind this particular medication is that it acidifies your urine, causing the urine to provide an unfriendly environment for bacteria. In the past, it was used to prevent uti's, along with Vitamin C. Given that the urine needs to be in your bladder for about 4 hours for this to have any effect, it is not useful for anyone who uses an indwelling catheter.

As far as I know, there is nothing in the literature that shows us that this works in individuals with a spinal cord injury.

Remember also, that the d-mannose only works on certain bacteria. Specifically, e. coli.

If you believe that you have a UTI, please do not screw around with it. Drinking a lot of fluids only masks the symptoms. Once you decrease your fluid intake, you may likely still have the infection. All the fluids did was dilute the number of colonies per cc of liquid.

ckf

[Quad Marie]

My symptoms started on Wednesday so I might wait till Monday to bring in a sample just to see if anything clears up. So uroquid is no good for me but d-mannose is? Ecoli is the reason for a lot of UTIs. What is the right dosage because the bottle says take 3 pills anywhere from 1 to 3 times a day. Is 3 pills just once a day good? Also besides drinking water is there any other good preventatives for a person with a indwelling suprapubic catheter? I do the renacidin flush but not as much as I need to.

[SCI-Nurse]

While d-mannose works for E.coli, you do not know that is what you are growing. It probably doesn't hurt to take it, but it may not be doing any good. Monday is a long way off. I would encourage you to get seen or at least talk to your PCP today. Why suffer?

Other preventative measures include staying away from caffeine (or at least decreasing your intake), not letting your bag get too full, staying away from sugary beverages and foods, and just taking good care of yourself.

ckf

[Quad Marie]

I am still getting chills, increased spasticity/ twitching, and increased nerve pain but I feel like it is something I could live with. My urine is relatively clear except for some floaties and maybe a little cloudiness. I'm getting to the point when I'm not quite sure it is appropriate to bring in a urine sample to get treated. Sometimes I get headaches with my UTIs but not this one just my typical symptoms of chills and twitching. I would normally bring in a urine sample but if there is always bacteria I don't want to build up a resistance. I just want this one to go away so I can start with a clean slate of drinking water. Should you take probiotics while on antibiotics?

[gjnl]

You should absolutely take probiotics when you take antibiotics.

There may always be bacteria in your urine, but the key is the CFU (Colony Forming Units count). In the general population a CFU of 10,000+ may not concern a urologist, but in someone with a spinal cord injury and complex urinary tract infections, 10,000 CFU may be significant for treatment. It all depends on the bacteria and your circumstances. Taking a specimen of urine to the lab for a urinalysis (UA) may not tell the entire story. You need to have a culture and sensitivity (C&S) to find out if there is an infection and if there is an infection, to what is that infectious bacteria is sensitive. Taking a urine sample to a lab does not automatically mean you will be prescribed antibiotics. It is always best to get a urine specimen tested with at UA and C&S if and when you suspect a problem.

All the best,
GJ

[xsfxsf]

Okay I do think I have a legitimate UTI because I am getting intense chills and my urine has gotten cloudy but I do not want to send it for a culture just yet.

Personally, I immediately get C&S if I feel like I might be coming down with a UTI (I look for slight temperature, cloudiness, chills, and nausea personally). The reason for this is that if the symptoms keep getting worse and I do need antibiotics, I don't want to wait the extra couple days - or more on a weekend - to get the results back from the C&S while being treated with a possibly inappropriate antibiotic. Fortunately, for the last two years I've never had to use an antibiotic, my symptoms have always gone away in a few days on their own and with increased water intake, but I do wind up needing C&S's a couple times a year.

So, I don't think there is any reason to be reluctant about getting a C&S, nothing is gained by delay.

Of course, I am very lucky to have found an unusually patient and skilled urologist who doesn't seem to mind the extra paperwork and who really seems to want me to be healthy (I use a suggestion I think I heard from gjnl: I have the urologist just give me a bunch of blank C&S forms each year and I take them right to the lab if I need one so I don't have to go into the urologist's office).

[fuentejps]

have you tried hiprex? old drug but appears to be effective and helpful.

[Quad Marie]

My urologist doesn't mind me bringing in urine samples and will not put me on antibiotics until a culture and sensitivity test is done but to try to avoid antibiotic resistance he always encourages me to wait to bring in a sample until my symptoms are more than just a little mild. I just don't seem to be getting any worse just the same . I might try changing my catheter. He has suggested getting on this if I wanted to: http://www.theralogix.com/product-li...-theracran-hp/

I am already taking the theralith XR to help prevent stones which I've only had one other time since having an indwelling catheter.

[SCI-Nurse]

Good urologist- he should wait - and not overtreat-unless you have moderate to severe symptoms - and it is a long weekend and you might get septic (spread to blood). The latest research shows the concentrated cranberry extract helps- but again preventative. See other post- I do not want my patients- or most of them- to wait past mild symptoms.
Recommend starting on this- might have to clear a UTI to start clean and then with symptoms like cloudy, foul smelling urine- more water etc.. see if it clears. Depends on the organism and your history.
As mentioned, physical symptoms- mild I like to test but wait to treat. Because it takes so many days to get it back.
Don't have experience with Theralift XR - have you had stones before?
CWO

[SCI-Nurse]

Theralift XR-...extended-release magnesium, potassium citrate, vitamin B 6 supplement formulated to support and maintain normal urine chemistry. (B6 is good for your brain). Will ask our urologist!
But to me if you have stones they should analyze it and there is a urine test for stone formation.
Most SCI pts have stones of struvite- an infectious material. The research mentions those with weight loss surgery and calcium oxalate stones.

I always recommend a multivitamin with minerals for everyone!
CWO