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Dr Chaithanya
Dr Chaithanya, General Physician, Medical Researcher, All medical and health questions answered.
Category: Urology
Satisfied Customers: 798
Experience:  General Physician, Family medicine, Internal medicine, all age groups.
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I am an 89 year old woman. I have had many re-occuring utis

Customer Question

I am an 89 year old woman.
I have had many re-occuring utis
My second last one was in Dec.
Took 1000mg vitamin c for 4 months and okay
Recently had another ecoli uti.
It was quickly remedied within 1 day of taking macrobid
I took it for 10 days at 200mg daily.
My son confirmed the urinalysis to be negative on day 10
4 days later I had signs of another bladder uti
I have taken mannose this week and had minimum symptoms - only 2 incontinence episodes within 4 days.
My wbcs were high at 500 and had had nitrites, rbcs and protein.
We saw a urologist a few weeks ago and he didnt care much as I had been uti free for a few months and never any
wbcs in the urine so no real infection just vaginal contaminates for ecoli
I am 30lbs overweight have diverticulosis.
How can I get a relapse so quickly.
I wont qualify to get a catscan or cystogram
I am so frustrated and have chronic spinal arthritis which has flared up too.
My son reports that my wbcs were okay in the blood though.
Help with some good advice
Submitted: 1 year ago.
Category: Urology
Expert:  Nadim Al-Mubarak replied 1 year ago.

Some people are just predisposed to get UTIs for variety of reason. Immunodeficiency is one of the reason why. But also the need for frequent catheterization, incontinance and anatomical abnormalities. Frequent UTIs by itself can predispose you to have more as it creates an environment within the urinary tract that lead to future UTI. Some bacterial UTIs never completely resolve with the antibiotics and once the latter is stopped, the infection relapse

My advise to you is to see a Urologist as well as a hematologist to evaluate for possible anatomical problem and to investigate possible weak immune system.

Let me know if you need more clarifications

Customer: replied 1 year ago.
That didnt help much - I request another expert - please opt out
Expert:  khagihara replied 1 year ago.

Do you have urinary incontinence? Prolapse of the bladder? Postvoiding residual urine? Have you tried vaginal estrogen?

Customer: replied 1 year ago.
I only have incontinence when I have ecoli infections. I dont know if I have a prolapesd baldder. I did bear three children.
I had an abdominal ultrasound with no urine retention. I am 30lbs overweight. Due to my spinal arthritis I have hygiene problems. I am on premarin already. I was 4 months uti free with 1000mg vitamin c.
I was on nitro for 10 days and my son did the urinalysis on 10 day - it was negative and urine clear.
4 days later another ecoli probably.
The mannose has helped but probably wont cure it. I am almost 90
I am tired
Expert:  khagihara replied 1 year ago.

Do you have diabetes?

Customer: replied 1 year ago.
Expert:  khagihara replied 1 year ago.

You should try to use trimethoprim-sulfamethoxazole as continuous prophylaxis. The use for as long as five years has been reported to be effective and well-tolerated. Talk to your doctor.

Customer: replied 1 year ago.
I am resistant to bactrim and you didnt really answer the other questions.
I would ask you to opt out now. Thankyou for your attempt
Expert:  Dr Chaithanya replied 1 year ago.


I'm Dr Chaithanya, experienced Physician attending you now

Let me help you.

Nitrofurantoin [Macrobid] is the right choice of antibiotic when you have bactrim resistance,

But, it is rare chance that after 10 days of Macrobid treatment and when urine analysis shows negative, you get back infection in 4 days.

What are your present symptoms that confirm the recurrence of UTI?

[This is not final answer,..]

Expert:  Dr Chaithanya replied 1 year ago.

For recurrent UTI's continuous prophylaxis is recommended.

Nitrofurantoin (Macrodantin) can be taken at 50mg to 100mg dose per day, in divided doses, [dose will be suggested based on the severity]. It is recommended for 6 months in most of the patients. Again your doctor decided the duration of treatment based on the recurrence history and severity,

Expert:  Dr Chaithanya replied 1 year ago.

If you haven't tried cranberry juice, I recommend to try. It shows good results in preventing UTI's especially recurrent UTI's in women. You can have it around 200ml per day/ continue for 6 months

Expert:  Dr Chaithanya replied 1 year ago.

I also want you to get a gynaecology check up once to ruleout prolapse and so that has to corrected to stop incontinence and recurrent UTI's. You also try vaginal mild estrogen cream.

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Customer: replied 1 year ago.
A glass of cranberry juice will not do anything meaningful.
I am sorry your answers do not help at all.
Please opt out
Expert:  Dr Chaithanya replied 1 year ago.

I want you to have some respect to doctors. You asked 3 doctors to opt out. Are you doing doctor shopping here?

Sorry, not the right way!

Customer: replied 1 year ago.
Question may be closed off - thankyou Ingrid