Have Urology Questions? Ask a Urologist Online.
Don't follow most of your response.
If all the bacteria are killed, then how can you a UTI?
And if can still get a UTI, then how do you know as a patient that you have a UTI? What are the symptoms?
How would a doctor diagnose whether you had a UTI if taking antibiotics?
And if as you say many older patients have UTI without symptoms, isn't that dangerous? If so. what do you recommend to avoid this?
Thank You. I have follow-up questions that will be asked as a new question(s).
Ok. Please clarify initial statement that culture will also come negative, and later apparenlty conflicting statement that UTI can be diagnosed with a urine test and urine culture only.And if no bacteria means no UTI, then UTI must mean bacteria. So why wouldn't the strips work? But a culture would work (see first sentence above).
I think you are missing my point.
I am taking Nitrofurantoin as a prophylactic against UTI’s (100 mg/day for about six weeks now), Can I still get a UTI? Only if the bacteria becomes resistant to the Nitrofurantoin? I have heard it is possible, but probably not after just six weeks. I have heard various opinions; my pharmacist says she knows of several men and women using Nitrofurantoin as a prophylactic for years without a problem; yet, one urologist said that taking Nitrofurantoin every day will result in resistance 100% of the time.
You state that the culture will come back negative if the urine is sterile - that is devoid of bacteria as they are killed by the bacteria. But if somehow the bacteria becomes resistant, you can still get a UTI. Would that not be detectable by a strip and/or culture since now bacteria are present?
So the only way you can obtain a UTI if taking Nitrofurantoin is if the bacteria becomes resistant, or can you get a UTI even if the bacteria does not become resistant? One reason I ask if that an expert told me that for the amount of urine I retain, that 50 g per day would not be sufficient; e.g., bacteria greater than Nitrofurantoin can handle.
How likely is it to receive a UTI while taking Nitrofurantoin? What have you seen as far as resistant strains of bacteria evolving? Have you seen doctors alternate between Nitrofurantoin for a period of time than switching to another antibiotic for another period of time and then back again to prevent this from occurring? Your opinion/recommendation? Thank you.
I went to Urgent Care this afternoon after AZO test strips at home showed positive for leukocytes twice. The sample at urgent care showed low in leukocytes and the doctor prescribed 250g of Cipro twice a day for five days. Does that sound reasonable?
I have concern in that my symptoms were not overwhelming, and I don't know long how I may have had the UTI (that is, if the culture comes back positive). No blood was found in the urine.
I asked the doctor if after the 5 days it was safe to go back on the nitrofurantoin as a prophylactic, and he said that in the 5-day interim that may help defeat the resistance, and said we would cross our fingers that that would be the case. What is your view on that?
I finally have my appointment to see a new urologist on Thursday, May 16th. Perhaps I should ask her about cephalosporins as a prophylactic for UTI's. What is the cephalosporin usually prescribed. Doesn't that have the same concern for resistance? Should a patient rotate prophylactic antibiotics monthly to avoid this. I generally retain 300-400 ml of urine: I take it that makes it more likely for me to develop UTI's when using a catheter even with antibiotics?
I never had a UTI unless using a catheter. I am wondering whether in a risk/benefit analysis it is better for me not to use a catheter and risk any damage to my bladder from retention? I have had no kidney problems to date but worry that UTI's from catheter use could result in that. The only side effect to date is a thickening of the bladder wall.
I have asked quite a few questions here. Feel free to answer some, and I will ask the remainder in a new question to better compensate you for your time. Thank you.