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Nadim Al-Mubarak
Nadim Al-Mubarak,
Category: Medical
Satisfied Customers: 378
Experience:  MD at University Hospital Case Medical Center
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58 Yr Old Male, ended up in emergency room Sunday night with

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58 Yr Old Male, ended up in emergency room Sunday night with blood and little tiny blood clots in urine, great pain during urination, urgency. They tested blood and urine and gave me an IV of Cipro and then 20 Cipro tablets, 500mg twice a day for ten days. It is now Friday night, I have taken the Cipro for five days and I am really no better than I was. There does not appear to be any more blood but the tremendous pain and constant need to urinate continue. I am able to pass urine. The pain is not only in the urethra but in my low abdomen just above the penis, the lower belly area. Half of my friends say I should just bear up, keep taking the Cipro and it will eventually kick in. The other half of my friends say I should feel much better by now. So instead of reliance on my IDIOT FRIENDS, I decided to ask an actual doctor! I take glypizide for diabetes which is totally under control and atenolol, benazepril, Isosorbide DN for HPB which is also totally under control. What to do?
Submitted: 5 months ago.
Category: Medical
Expert:  Nadim Al-Mubarak replied 5 months ago.
GreetingsYes, you should be much better by nowEvidently, they treated you for urinary tract infection (UTI) with a good choice Antibiotic, but after 5 days, there is no response (with the exception resolution of the blood). The symptoms of UTI persist and therefore, you do need to be re-evaluatedI would recommend to go the same ER for Re-evaluation. They should have sent some of your urine for culture before they started you on Cipro and the results should be available by now. This test identifies the specific bacteria responsible for your UTI and whether is it responsive to Cipro. It will also identify the correct Antibiotic to be usedLet me know if you need any further clarification. If done, please complete the stars rating as this is how we get credit for our service. You may still email me with questions about this issue after the rating. Best wishes
Expert:  Nadim Al-Mubarak replied 5 months ago.
Note: it takes few days for the urine culture results. The result could not have been available during the first visit.
Expert:  Dr. Thomas, MD replied 5 months ago.
HelloI am Doctor Thomas, a double board US certified doctor in internal medicine and integrative medicine, with advanced training in several other fields. I am a clinician of over 20 years experience. I will give you an initial answer or ask you a question, but be sure to use reply to expert to communicate with me as needed.Cipro can no longer be considered a good choice for UTIThere are many reports on this. Too much resistance.Even bactrim is now failing as a fist line medication.Do not WAIT on changing the antibiotics, in other words, do not wait on the culture results. You have given no indication they did a culture. They would have told you, and they would have called you if the result did not fit the antibiotic they gave you [it would be illegal in the US for them not to inform you]. Therefore, it is not likely you had a culture, and you would have to get that now. There are other problems here, though, which I will now go into.The indicated medicine in this case, and tell them after they get the culture, would be a third generation cephalosporin.In addition, being a male, prostatitis needs to be ruled out.If this is the problem, 2 weeks or more of doxyciline would be a good choice.In addition, prostatitis would also explain a non response to cipro, and a response to any medication in prostatitis would be slower.As a male, you need to see a urologist for follow up to rule out such anatomic problems: in other words, why would a male even get a UTI.I am a double board certified US doctor.Find me, Dr. Thomas, any time for correct, safe and up to date medical answer.I am here daily./Please click a positive on this post only if you want me to receive pay and credit.Let me know if yo have problems [or customer service]Find me as needed.Good luck.
Expert:  Nadim Al-Mubarak replied 5 months ago.
Cipro is still an effective antibiotics, but the proper antibiotic is the one that has been tested on your urine. It might be "illegal" not to tell you that they cultured your blood, but it is not illegal to forget. The culture obtained prior to starting cipro is far more valuable than the one you would do now. We should not speculate. You need to check with the ER and ask if they did culture your urine or not. Would appreciate it if you complete the stars rating. Best wishes