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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18533
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I just got a UTI today around 2pm. I stopped taking Bactrim

Customer Question

I just got a UTI today around 2pm. I stopped taking Bactrim and cipro early because I had reactions to it. I went five days or so without any symptoms. But then I had blood in my urine so I made a trip to the health clinic on campus & they said I have a low amount of bacteria or white blood cells in my urine. They prescribed macrobid to me. I took it around 4pm. During these five days I was taking d mannose & my doctor said that's probably what kept it at bay. Is there still a chance that the medicine will not work & that I will get a kidney infection?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. D. Love replied 1 year ago.

Hello from JustAnswer.

It is possible, but it is a very low risk. As a baseline risk, it is a small percentage of bladder infections that will progress to a kidney infection, and once an antibiotic is started, the risk is dramatically lower. It cannot be said that the risk is zero until the infection is eradicated, as there is always a chance that the specific germ is resistant or may become resistant to the antibiotic being used, but the risk is quite low.

I would note that the evidence on D-mannose is that it is much better at preventing urinary infections in people that tend to get recurrent infection but not as good at eradicating infections once they are established. However, it has not been specifically studied on whether it is effective at preventing the progression of a bladder infection into a kidney infection.

If I can provide any clarification, please let me know.

Customer: replied 1 year ago.
Is there any way I can text you instead
Expert:  Dr. D. Love replied 1 year ago.

I can initiate an Additional Service offer for a phone call, but not for texting. If that would be of interest to you, please let me know.

Customer: replied 1 year ago.
Never mind! So in taking macrobid at 4pm, there's minimal risk of a bladder infection. But after ten days, what is the risk of getting a recurrent UTI? Should I start taking d mannose after I am done with the medication to prevent further UTIs?
Expert:  Dr. D. Love replied 1 year ago.

To clarify, if you were diagnosed with a UTI, then you already have a bladder infection. You asked about the risk of it becoming a kidney infection, and it is a minimal risk that it will develop into a kidney infection.

It is usually not necessary to consider D-mannose for prevention unless there is additional history that you have not yet relayed. With the history that you describe, this is not as much a problem with a second infection as it is more likely that the original infection was never completely treated, since you had to quit the Bactrim and Cipro early because of adverse reactions.

If you complete the antibiotic course and eradicate this infection and remain symptom-free for several weeks, and then develop recurrent UTIs or if you have a history of several UTIs over the course of a year, then that would be the point at which it is usually considered to use D-mannose for prevention of recurrent UTIs. If you already have a history of previous UTIs over recent years, then you may have met this threshold.

Customer: replied 1 year ago.
Ok let's clarify this, I'm gonna summarize what you have told me. I have a bladder infection. The risk of me getting a kidney infection is a low risk because I just took the macrobid. This is not another UTI you are saying, because this is most likely a UTI from two weeks ago that wasn't cleared up because of my adverse reactions with cipro and bactrim. If I finish this medication & all the symptoms are gone. I shouldn't really worry about taking d mannose unless I keep getting recurrent infections
You're right about me not having past UTIs. I've only have had a really bad one my senior year of highschool in 2013, & have just gotten one & it's 2015.I haven't really done anything to prevent them in the past either. I've sat in dirty water from oceans & lakes & have never gotten a UTI. So I think my body has a pretty high tolerance to them. I'm just surprised that my body is doing this again.
Expert:  Dr. D. Love replied 1 year ago.

Yes, this clarification is correct.

UTIs are fairly common in women, and two infections two years apart are not an excessive rate of infection.

Customer: replied 1 year ago.
Also the weird thing is, I'm having a really easy time going to the bathroom (no pain or burning) & I don't have frequency like I did this morning. When I was taking d mannose after quitting Bactrim on Friday night, I felt fine & had a little bit of urgency. So do you still think the UTI was with me that whole time? Even when I first got symptoms & was put on cipro my symptoms weren't horrible but they still think it went to my kidneys. Does this mean this UTI has a low bacteria count all in all? Sorry for asking so many questions. I rarely get UTIs & this is bothering me because I don't want another one again. They truly cause me anxiety.
Expert:  Dr. D. Love replied 1 year ago.

When the symptoms are not as severe, it is typically due to a low amount of inflammation caused by the infection, and a relatively low count of bacteria is one of the reasons for a lesser amount of inflammation. But it is not the only reason. Some woman seem to be more or less sensitive to bacteria growing in the urine, so may have more or less inflammation, regardless of the count of the bacteria. There are also certain bacteria that tend to be more aggressive than others, so the specific germ also could be the reason for more or less inflammation.

I understand that this is causing you anxiety, but UTIs in women are very common. It causes between 6 and 7 million office visits each year in the US.

Customer: replied 1 year ago.
Can stress & previous illness cause this also?
The week before I was sick with a mild cold.
Maybe my immune system is under the weather.
Expert:  Dr. D. Love replied 1 year ago.

Stress increases the risk for any infection. There are studies that show that children living in homes with parental discord are more likely to develop Strep throat. A previous viral infection could have a generic stress effect. A cold, though, would not have a direct effect on causing a UTI.

As for other illnesses that have a more direct effect on contributing to urinary tract infections, there are certain anatomic abnormalities in the urinary tract that predispose to infection, but these are relatively rare, so are a cause of only a small percentage of UTIs. Any condition that interferes with flow of urine also can contribute to the development of infection, such as kidney stones. But the vast majority of UTIs are not related to any of these diseases.

There also are certain lifestyle factors that increase the risk for UTIs, including drinking low levels of fluids, so that the bladder is not emptied as often, and sexual activity. The germs involved in UTIs are not sexually transmitted germs, but it is thought that the mechanical manipulation of the urethra during intercourse allows for germs to enter the bladder. This is actually a bigger risk for women that are suddenly more sexually active. This can occur during honeymoons, and is referred to as honeymoon cystitis. I also see this in some patients that are married to men that are seen infrequently, such as in the military or travel long distances as part of their job, so that there are periods of abstinence followed by frequent sexual activity, and UTIs develop during the time of increased sexual activity.

Customer: replied 1 year ago.
This is anonymous right?
Expert:  Dr. D. Love replied 1 year ago.

Yes. All of your personal information is not accessible except by the office/billing staff. Even the experts cannot access the personal information. The only information visible to me is that you are a 21 year old female.

Customer: replied 1 year ago.
Okay. I think my UTIs may be caused by sexual intercourse. The first time I had it was with my current partner of four years & that was the UTI I had senior year of high school. I didn't seem him every week that year & didn't have sex with him much. But these past two years I've been able to be with him every Thursday & Friday & sometimes we have sex once or twice. Like i said I'm very lazy with after sex care & rarely get UTIs. But this one I think was caused by my period. My period came, it was done. Then I had sex with my current partner and I guess he managed to push bacteria into my urethra which led to the UTI a few days later. Like I said I have no idea how I get UTIs because I rarely get them & I'm surprised & quite shocked, confused that this could happen???? because I have had sex quite a lot with no problems.
Customer: replied 1 year ago.
I'm trying to pin point the trigger so that I can be smarter after this. Having UTIs once in a while is normal to me but I don't want to be stuck with this every time I have sex.
Expert:  Dr. D. Love replied 1 year ago.

It certainly is possible that intercourse contributed to this infection. It would be reasonable to be drinking plenty of water, particularly on days on which you anticipate that you may be sexually active, and to empty your bladder shortly after intercourse. It is not necessary to interrupt any post-coital cuddling, etc., but once the intimacy is completed, then emptying your bladder should be one of your first acts.

Customer: replied 1 year ago.
Does dirty underwear cause UTIs
Customer: replied 1 year ago.
The only way to completely cure a UTI is through antibiotics? But then how did I stop a UTI with cranberry my senior year?
Expert:  Dr. D. Love replied 1 year ago.

No, not really. Poor personal hygiene can contribute to UTIs and women that wear dirty underwear may have poor personal hygiene, but relatively few UTIs are directly related to poor personal hygiene.

I never said that the only way to completely cure a UTI is through antibiotics. It is true that for certain infections, a full course of antibiotics is necessary to completely eradicate a UTI, which is likely why the first symptoms this time did not resolve when you did not complete a course of antibiotics. But before antibiotics were invented, it is not that once a woman got a UTI, then she remained infected for the rest of her life. The immune system can get rid of many infections, although it may take longer to do so.

Customer: replied 1 year ago.
Does lack of sleep contribute to UTIs? The night before I got my UTI. I did not sleep well at all unrelated to the UTI.
Expert:  Dr. D. Love replied 1 year ago.

Not directly. Poor sleep can create a generic stress effect, although it usually requires more than one night of poor sleep.

Customer: replied 1 year ago.
Where is kidney pain usually felt in kidney infections?
Expert:  Dr. D. Love replied 1 year ago.

I am sorry about the delay, but I was away from the computer.

Usually in the back or the flank/side of the abdomen.

Customer: replied 1 year ago.
Is it possible to have an asymptomatic UTI for like 3 years & then have it flare up because it wasn't treated properly the first time? My doctor told me that what could have happened when I drank the cranberry juice for the first UTI I got my senior year.
Expert:  Dr. D. Love replied 1 year ago.

It may be possible, but it would be extremely unlikely.

Strictly speaking, having a germ in the urine without symptoms would be called asymptomatic bactiuria, not an asymptomatic UTI. Bactiuria is a term that only means that there is bacteria in the urine. The vast majority of people with asymptomatic bactiuria do not progress to a UTI, and usually resolve spontaneously, so we typically do not treat asymptomatic bactiuria. Since we do not treat it, we also usually do not even look for it.

So, while it is possible that the germ continued to grow in the urine for years to later cause an infection, this is not typical for how germs exist in the urinary tract.

Customer: replied 1 year ago.
Is it possible to get a UTI infection while taking antibiotics for the UTI in the first place? I didn't have symptoms for two days & I even went to another doctor yesterday who tested my urine and said it was clear. I had a little burning this morning while peeing. I'm on Macrobid but the generic version
Customer: replied 1 year ago.
no more burning but just a teeny bit of urgency.
Expert:  Dr. D. Love replied 1 year ago.

It is not common in that sense, but as I noted above, there is always a chance that the specific germ may become resistant to the antibiotic being used, so the patient may notice a worsening of symptoms while taking antibiotics, but it is not really getting a new UTI.

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