Dr. N. Ashok Viswanath
Infectious Diseases
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have recently been diagnosed with UTI, and it is six weeks to postpartum. I also have a 3-year-old kid. I took Amoxicillin for four days and then retested it on the fifth day, which is still there. I was told that it was resistant to moderate oral antibiotics. I have also done a urine culture test and am attaching the reports. Kindly suggest.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern. I have seen your laboratory reports (attachment removed to protect the patient's identity). Is this laboratory report a newer one or an older one? What are the symptoms that you are facing?
Thank you.
Patient's Query
Hello doctor,
The second laboratory report is the recent one. The first one with susceptibilities is the previous one. The symptoms that I am having are a burning sensation during urination (not constant) and lower back pain. So I was given Meropenem intravenously, considering that I am resistant to oral antibiotics. Meropenem 500 mg every six hourly. But my question is, was that dosage enough? Also, I was told to take Fosfomycin 3 gm sachet once. I am currently breastfeeding. How long should I stop breastfeeding after taking Fosfomycin?
Kindly suggest.
Hello,
Welcome back to icliniq.com.
In the oral antibiotic group, I can see Nitrofurantoin (susceptible). Are you facing any symptoms like painful urination, lower abdominal pain, and fever? For now, again, you can get urine tested for culture and sensitivity. Kindly provide a clean catch mid-stream urine sample. Do not catch the initial part and last part of your urine sample. Catch only the middle amount of urine in a sterile container and get it tested for culture and sensitivity. Apart from that, besides antibiotics, hydration plays a major role in eliminating urinary bacterial pathogens. Drink at least two to three liters of water per day. You can use supplements containing cranberry extract and D Mannose. Both of these will help in faster recovery from urinary tract infection.
Thank you.
Patient's Query
Hello doctor,
I have lower abdomen pain and a burning sensation during urination. Can I use D Mannose while breastfeeding? Also, how many days should I stop breastfeeding while I take Fosfomycin? Is my UTI due to ESBL bacteria? How do I know that it is due to ESBL bacteria from the report? Kindly suggest.
Hello,
Welcome back to icliniq.com.
You have an infection with ESBL E. coli (extended-spectrum beta-lactamases producing Escherichia coli). I can interpret it as the infection is resistant to Ceftriaxone, but susceptible to Piperacillin tazobactam. Yes, D Mannose is safe during breastfeeding. The amount of drug which goes out through milk is very less and does not cause any issues in a child. There is no need to stop breastfeeding during Fosfomycin treatment.
Thank you.
Patient's Query
Hello doctor,
Is D Mannose during breastfeeding safe? You mentioned its use in pregnancy. Also, I am attaching my recent report without using any antibiotics in between. Kindly suggest.
Hello,
Welcome back to icliniq.com.
D Mannose is safe during pregnancy, post-pregnancy, and breastfeeding periods. This report (attachment removed to protect the patient's identity) looks normal other than low urine-specific gravity, possibly due to dilute urine (nothing to worry about). You can use supplemental D Mannose and cranberry extract and stay hydrated to avoid urinary tract infection.
Thank you.
Patient's Query
Hi doctor,
Yes the burning sensation is reduced and I will start taking D Mannose and cranberry extract.
Hello,
Welcome back to icliniq.com.
I hope the suggestions help.
Thank you.
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Infectious Diseases
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