My mom has persistent UTI and E.coli infection for almost a year. Can she take Nitrofurantoin?

Question

Hi doctor,

I require your kind advice regarding my mom's medication. She is 53-years-old. You see, my mom had persistent UTI and E-coli infection for almost a year. Her health deteriorated due to which she had a fall last year and got fractures in her spine and right shoulder, for which she was operated with screws and rod insertions, i.e., dorsal spine fixation and proximal humerus plating. However, she had incidents of granulation tissue pouring out on the spine suture area twice after the initial surgery, due to which she had been operated on two more times to sort out the problem. The reason for the granulation tissue pouring out was described as being due to high UTI and E-coli infection. She took IV antibiotics for seven weeks and was also prescribed Nitrofurantoin 100 mg for a year which would completely eliminate her UTI and E-coli. My mom, however, had it only for five months and quit. It has been four months now since she quit, and now suddenly, she is experiencing frequent urination, overactive bladder, and urine incontinence for three days. Also, there is inflammation during urination. Kindly suggest to me if there is no harm if she starts Nitrofurantoin 100 again and for the remaining seven months or any other period?

Answer 1

Hi,

Welcome to icliniq.com.

I hope you are doing well.

I understand your concern and worry.

I understood that your mother had a fall and dorsal spine injury. Since then, she has recurrent urinary tract infections. Our understanding of any disease management has based on the cause of disease or symptoms.

For the same, we require a detailed patient history and perform a pelvic examination as well as repeat urine studies when an initial urine specimen. At present, your mother has acute urinary tract infections like cystitis. First-line therapy (i.e., Nitrofurantoin) to start is reasonable and generally no longer than seven days. You should get a urine study and culture to know about the infection. If culture comes positive, culture-directed IV or oral antibiotics for as short a course as reasonable. Once the symptoms subside, you can start prophylaxis (Nitrofurantoin). The duration of antibiotic prophylaxis in the literature ranged from 6 to 12 months. Guidelines also suggest cranberry juice as prophylaxis for women with recurrent UTIs. Cranberry can be used in a variety of formulations, including juice, cocktail, and tablets. Vaginal estrogen therapy is also recommended in the guideline for postmenopausal women to prevent infection. It comes as a vaginal cream (17β-estradiol) 2 g daily for two weeks, then 1g 2 to 3 times per week. Maintaining hydration, exercise are other things that help in preventing UTI.

If recurrent UTI persists, I would suggest taking the opinion of a urologist.

I hope this helps you.

Regards