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  • Intravesical gentamicin is a winner

    Just to re-introduce myself... I'm a C6 since 1980. I've been plagued with UTI culminating in kidney infection ever since. Over nearly four decades I have tried literally everything I could find to beat this problem. Thanks to a member here, supporting his father, I decided to try intravesical gentamicin (iGM). I wear a condom style catheter so it's not a natural fit for me. But when you've run out of options you make things work.

    I looked up the protocol with a simple google search, printed out the studies and convinced my doctor. It was the easiest thing I've ever done.

    Six vials (4ml each) containing 80mg of gentamicin diluted in one liter of normal saline solution. You end up with a solution of 480mg gentamicin per 1.024 liter of saline. First, you empty your bladder. Then, using a syringe without a needle, you inject 30ml to 60ml of the solution through the catheter into the bladder. The gentamicin is later passed from your bladder with your urine however you normally do that.

    I started doing the procedure with 30ml every other day due to my doctor being wary. I didn't like it because I would still sometimes see pus or sediment. So, I started doing 30 ml everyday. That was better but kind of a hassle and still occasionally would see pus or sediment. So, I've settled on 60ml every other day. It's more convenient and I never observe pus or sediment.

    Do a google search and read everything. They tried this procedure with colistin and neomycin and various combinations but all those efforts resulted in significant microbial resistance and ultimately failure. Something about gentamicin at a higher concentration renders microbes unable to resist it. The higher concentration also makes gentamicin effective against all kinds of strains that systemic administration won't touch, including gram positive ones. If you're carrying a gentamicin-resistant bug that means an intravenous dose will not help. However, iGM will likely still do the trick.

    It's been over six months and life is a dream. My urine is always crystal clear. There is nothing like iGM for prevention. I only wish I had tried it a long time ago.
    ~See you at the CareCure-used-to-be-paralyzed Reunion ~

  • #2
    AGREED. it has been shown to drastically reduce resistance. manyyyyyyyyyyy sci's do it and have been for many years. no side effects like orals either.
    Bike-on.com rep
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    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

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    • #3
      so, are you saying that gentamicin can be used to treat as well as prevent?
      "courage is fear that has said its prayers"

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      • #4
        Originally posted by Jeff View Post
        Just to re-introduce myself... I'm a C6 since 1980. I've been plagued with UTI culminating in kidney infection ever since. Over nearly four decades I have tried literally everything I could find to beat this problem. Thanks to a member here, supporting his father, I decided to try intravesical gentamicin (iGM). I wear a condom style catheter so it's not a natural fit for me. But when you've run out of options you make things work.

        I looked up the protocol with a simple google search, printed out the studies and convinced my doctor. It was the easiest thing I've ever done.

        Six vials (4ml each) containing 80mg of gentamicin diluted in one liter of normal saline solution. You end up with a solution of 480mg gentamicin per 1.024 liter of saline. First, you empty your bladder. Then, using a syringe without a needle, you inject 30ml to 60ml of the solution through the catheter into the bladder. The gentamicin is later passed from your bladder with your urine however you normally do that.

        I started doing the procedure with 30ml every other day due to my doctor being wary. I didn't like it because I would still sometimes see pus or sediment. So, I started doing 30 ml everyday. That was better but kind of a hassle and still occasionally would see pus or sediment. So, I've settled on 60ml every other day. It's more convenient and I never observe pus or sediment.

        Do a google search and read everything. They tried this procedure with colistin and neomycin and various combinations but all those efforts resulted in significant microbial resistance and ultimately failure. Something about gentamicin at a higher concentration renders microbes unable to resist it. The higher concentration also makes gentamicin effective against all kinds of strains that systemic administration won't touch, including gram positive ones. If you're carrying a gentamicin-resistant bug that means an intravenous dose will not help. However, iGM will likely still do the trick.

        It's been over six months and life is a dream. My urine is always crystal clear. There is nothing like iGM for prevention. I only wish I had tried it a long time ago.


        so, are you saying that gentamicin can be used to treat as well as prevent?

        Edit / Delete
        "courage is fear that has said its prayers"

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        • #5
          Originally posted by jennypenny View Post
          so, are you saying that gentamicin can be used to treat as well as prevent?

          Edit / Delete
          I have been using as a prophylactic / to prevent for about 10 years. It put an end to recurring UTI's which started becoming a major problem at about 27 years post-injury.

          I have gotten one UTI in the last 3 years and I would say it's from me getting lazy on cathing because gentamycin was working so well i had unintentionally cut down on the frequency of cathing. When I got a UTI urologist treated with an oral antibiotic.

          For me, it has been an effective prophylactic rather than a treatment for UTI.

          "New Mobility" article on irrigating / installation:
          http://www.newmobility.com/2015/12/b...ant-solutions/

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          • #6
            What kind of medical insurance coverage do you have and how much is it running cost wise on the schedule you describe (60 mil every other day)?

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            • #7
              Originally posted by crags View Post
              What kind of medical insurance coverage do you have and how much is it running cost wise on the schedule you describe (60 mil every other day)?
              And what kind of pharmacy fills the prescription? I live in northern California outside of San Francisco, and local retail pharmacies won't touch the prescription. Do you go to a compounding pharmacy? or mail order pharmacy?

              My urologist says he has prescribed it a few times, but getting the medication always ends up to be a major hassle for him, his staff, and the patient.

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              • #8
                my ins covers gent no problem, i get the 2ml/80mg vials and mix in saline. i get the saline from my urological supplier.....

                i had it filled at my target/cvs for a long time then there was a shortage so i started getting it filled at a hospital pharmacy. in network it was $38 per 90 day supply out of network at hospital pharmacy $140 for 90 days
                its meant to be used as a preventive not treatment
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                John@bike-on.com
                c4/5 inc funtioning c6. 28 yrs post.
                sponsored handcycle racer

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                • #9
                  I get it from Walgreens and CVS no problem, just don't expect them to compound it for you. I get gent for about $10 a month, plus saline and 60cc syringes, it's maybe $15. Compounding pharmacy wanted over $200 for the same prescription pre-compounded. Mixing the liquids is so easy it's just not worth it to go to a compounding pharmacy. Just get the components separate.


                  Originally posted by gjnl View Post
                  And what kind of pharmacy fills the prescription? I live in northern California outside of San Francisco, and local retail pharmacies won't touch the prescription. Do you go to a compounding pharmacy? or mail order pharmacy?

                  My urologist says he has prescribed it a few times, but getting the medication always ends up to be a major hassle for him, his staff, and the patient.
                  "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

                  "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

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                  • #10
                    Originally posted by Oddity View Post
                    I get it from Walgreens and CVS no problem, just don't expect them to compound it for you. I get gent for about $10 a month, plus saline and 60cc syringes, it's maybe $15. Compounding pharmacy wanted over $200 for the same prescription pre-compounded. Mixing the liquids is so easy it's just not worth it to go to a compounding pharmacy. Just get the components separate.
                    totally agree
                    here is the way mine comes, vials have at least a year shelf life
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                    • #11
                      Is it kept in the refrigerator after mixing, and if so does instilling a cold solution cause significant bladder spasm?

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                      • #12
                        no, i just mix a weeks worth and keep in bathroom
                        Originally posted by crags View Post
                        Is it kept in the refrigerator after mixing, and if so does instilling a cold solution cause significant bladder spasm?
                        Bike-on.com rep
                        John@bike-on.com
                        c4/5 inc funtioning c6. 28 yrs post.
                        sponsored handcycle racer

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                        • #13
                          I'm on Social Security disability and regular Medicare with a Medigap policy. I have a separate part D drug plan through AARP. I just checked and they cover gentamicin sulfate 2 ml (40 mg gent) vials, 25 miles/pkg.

                          One can get a 90 day supply (that they define as 90 day) of 75 vials for $27 34. Not bad.

                          I will have to calculate to see if their 90 day would conform to my 90 day at what schedule, every day, every other day, etc.

                          I buy saline and syringes anyway out-of-pocket so that will be an issue. I also can probably stop buying hydrocleanse, which is currently running me $183 for a two month supply. I do it every day. The gent would actually be cheaper. I can't see doing both.

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                          • #14
                            Just did some calculations according to what I can get and came up with the following:

                            each 2ml vial contains 40mg gent (my pharmacy only offers this size)

                            I can get 75 vials or 150ml or 3000 mg gent for a 90 day supply

                            mixing 480mg/liter saline would give me 6.25 (6250/480) liters of compounded solution (6250 ml)

                            if one instills 30 mL that would give me 208 instillations, more than enough for an every day schedule for 90 days, easily enough for an every other day schedule.

                            For those that have done it, do these calculations seem correct? If so, I don't even think I would need to get that much prescribed for a 90 day schedule.

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                            • #15
                              Originally posted by crags View Post
                              Just did some calculations according to what I can get and came up with the following:

                              each 2ml vial contains 40mg gent (my pharmacy only offers this size)

                              I can get 75 vials or 150ml or 3000 mg gent for a 90 day supply

                              mixing 480mg/liter saline would give me 6.25 (6250/480) liters of compounded solution (6250 ml)

                              if one instills 30 mL that would give me 208 instillations, more than enough for an every day schedule for 90 days, easily enough for an every other day schedule.

                              For those that have done it, do these calculations seem correct? If so, I don't even think I would need to get that much prescribed for a 90 day schedule.
                              i do a higher concentration. that pic is per day. 50ml morning and night. so i mix 3 vials of gent to 100ml saline daily.
                              Bike-on.com rep
                              John@bike-on.com
                              c4/5 inc funtioning c6. 28 yrs post.
                              sponsored handcycle racer

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