HomeAnswersUrologyurinary tract infectionWill I have any adverse reactions if I take the medicines for UTI?

What medicines should an anxious patient with UTI take to overcome it?

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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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iCliniq medical review team

Published At October 2, 2022
Reviewed AtJanuary 18, 2024

Patient's Query

Hello doctor,

I was recently on holiday to stay with my partner. On my day of return, I noticed a burning sensation in my bladder. However, I have had fullness in my bladder for the last couple of weeks or ten days and constantly need to pass urine. So, I underwent a test that showed I had a urinary infection. Today I got some antibiotics. I took one today in the morning. However, I struggle to take the second. I choked almost twice. I have had a previous history of aspiration into the lungs with capsules. So I did not take the second capsule tonight. I am going for another test tomorrow. Today, I had a migraine on the right side of my head and nausea. I went to the toilet a couple of times. I had migraines several times before. I need medicine tomorrow to fix my UTI. I am feeling very nauseous and anxious. Could you please reassure me about the UTI? I am going to attach files of my report from the test. I consulted a doctor today, but he did not mention the capsule I need to take. Instead, he said that I have UTI, and it is not serious. Do you think, based on this, I will be alright? I will take the new form of tablets for three days. I hope nothing spreads to my kidneys. When should I take the tablets? Will I have reactions from the tablets?

Hello,

Welcome back to icliniq.com.

Do not take the prescribed antibiotic if it causes side effects. I suggest you take the tablet Augmentin (Amoxycillin and Clavulanic acid) 1 gram daily for a week. Consult a specialist doctor, discuss with them and take medications with their consent. Nitrofurantoin is a bacteriostatic agent and is not also going to work efficiently.

Patient's Query

Thank you doctor for the reply,

I vomited, so I stopped taking it. My sensitivity test only shows certain antibiotics, and I am allergic to Penicillin. Is it possible that I can take the tablet Doxycycline or Trimethoprim?

Hello,

Welcome back to icliniq.com.

Doxycycline is not listed, so I cannot comment on its sensitivity, but I suggest you take the Septran DS syrup (Sulfamethoxazole and Trimethoprim) once daily for five days.

Patient's Query

Thank you doctor for the reply,

I will attach my culture and sensitivity test again, done two days ago. I started taking the tablet Nitrofurantoin but had migraine and vomiting, so I stopped taking it. I took the Trimethoprim suspension of 20 ml twice daily for five days. I am very worried because I am not noticing any improvement yet. My nausea is back. I could not sleep and kept urinating. Also, I am nervous because my report shows I am sensitive to Trimethoprim. I took 20 ml in the morning and evening, but I still feel this way and am worried that I am antibiotic-resistant. Is it normal not to notice change yet? My concern is that I constantly have nausea, and I am also having mild pain in my back.

Hello,

Welcome back to icliniq.com.

It is sensitive according to your report (attachment removed to protect the patient's identity). Therefore, I suggest you continue with tablets for ten days. You can repeat the culture after the third day of the antibiotic, and to avoid resistance continue for ten days. Please do share the culture result with me. For vomiting, I suggest you take the tablet Metoclopramide. Then, consult a specialist doctor, discuss with them, and take medications with their consent.

Patient's Query

Thank you doctor for the reply,

I have a new report to attach. It came back yesterday. So I shall attach it. It says everything looks clear, and all tests are negative but shows some amount of blood in the urine. Does it mean there is blood in my urine? I am feeling slightly better today and do not have much nausea. I have a burning sensation. Do you feel, based on this, that the medication is working? I took the last dose a few days ago. I am told to take another one after the dose is finished.

Hello,

Welcome back to icliniq.com.

The result (attachments removed to protect the patient's identity) is great. I suggest you continue with the tablet Trimethoprim as we are doing well. You can do a urine culture after tomorrow and see the result. Then you need to complete the antibiotic course. I suggest you undergo an ultrasound for further evaluation and take 200 mL of yogurt daily.

Patient's Query

Thank you doctor for the reply,

I will start eating cranberries from today. I also ordered D-Mannose powder. My doctor wants me to finish it. I just took my morning dose, but I got distracted. I have taken three to four doses. Will this affect the result? I am just a bit worried because I still have symptoms. I have a burning sensation sometimes but ironically, not when urinating. My bladder feels full still. I am nervous that I have got antibiotic resistance. Is there a blood or urine test to detect resistance? I am hoping it is not. What is your view on that?

Hello,

Welcome back to icliniq.com.

First, the urine culture should be done 48 to 72 hours after starting the antibiotic. Do not be confused regarding three or four doses. Second, if you are concerned about whether the tablet Nitrofurantoin causes resistance, do not worry. We will come to know from the urine culture test. If the result is positive, it will show resistance. Usually, bacteria get resistance after several days of antibiotics. Regarding the urine strip test, it is useless for infection. However, it can give some clues but will not be like a urine culture test.

Patient's Query

Thank you doctor for the reply,

I got the culture result from the other day, so I will attach it. It says all clear. What about my red and white blood cell range? I am still on the Trimethoprim antibiotic. I am nervous. Is it safe to add an extra dose? I am going to undergo another test for vitamins. I am really worried. Should I undergo the DNA sequencing test? Also, I would not do those strips again; as you say, I hope this resolves. I am worried I will develop resistance as I took nine Doxycycline capsules last year. I also took the tablet Nitrofurantoin. Is there a test for antibiotic resistance?

Hello,

Welcome back to icliniq.com.

The culture is negative from the attached reports (attachments removed to protect the patient's identity). Now no worries about white and red cells as, with time, they will subside after inflammation is completely gone. I suggest you continue taking the medicines for five to seven days. Do not worry about resistance.

Patient's Query

Thank you doctor for the reply,

I wanted to update you. I finished my liquid antibiotics. By Friday afternoon, I felt better. But Sunday evening, I had bladder fullness with some burning sensation. So I did other culture tests like we previously discussed. I sent this off yesterday morning. It says it is satisfactory, but I am worried about the hidden bacteria. Why do I have these symptoms? What are these epithelial cells? Could you tell me your views? This is because the white blood cells do not come down, as far as I know. I have been drinking organic unsweetened cranberry juice mixed with water. Please suggest something. I took a complete blood count test this morning. I have attached two pictures of the test.

Hello,

Welcome back to icliniq.com.

The urine culture is negative, meaning no more UTIs (urinary tract infections). Epithelial cells are present in everyone. WBC (white blood cells) and RBCs (red blood cells) are there, and you have inflammation, not an infection. Most women have cystitis, which is inflammation of the bladder. The treatment depends on the histological examination. For example, chronic non-specific inflammation can be treated by simple alpha agonists. Do not worry. It is not a dangerous thing, and it can be temporary.

Patient's Query

Thank you doctor for the reply,

I never get UTI, and I do not remember the lingering symptoms. Do you think this infection can go undetected? Is the white blood cell count in that test high or normal? I cannot understand the readings exactly. I have a full blood count coming soon this week from a normal blood test. I do not have a burning sensation while passing urine. I hope this is not scarring tissue or damage that would lead to some permanent condition. I do not have any history of issues like this. I will leave off any invasive things for now and see how I do in the next two weeks. Is drinking cranberry alright? I do not see how I can end up with something chronic from this.

Hello,

Welcome back to icliniq.com.

Firstly the cause of interstitial cystitis (IC) is usually unknown. Second, there should be no WBCs (white blood cells) in urine. As I said previously, WBCs can decrease as you had UTI (urinary tract infection) before, and we should wait and then repeat the urine analysis after two weeks. Cranberries or mannose will not cause such symptoms. There is one important point for you to note sometimes vaginitis can cause such symptoms and should be diagnosed as a vaginal fungal infection. I got patients who presented with UTI and then were diagnosed to have IC, but not everyone is the same.

Kind regards.

Patient's Query

Thank you doctor for the reply,

I am writing you again for your professional opinion and expertise on this. Since we last spoke, I have done other cultures. Again it shows much of the same. The doctor said it will always be showing on their testing system.

Hello,

Welcome back to icliniq.com.

Your urine report (attachment removed to protect the patient's identity) shows RBCs (red blood cells) and WBCs (white blood cells) without bacteria, so this is inflammation (cystitis) of the bladder. The next step is to go for flexible cystoscopy and bladder biopsy. That will give us the proper diagnosis, and we then can decide on treatment better. This condition is called sterile pyuria and occurs due to stone, radiation, or atypical inflammation. A biopsy can show things better. Please do an ultrasound KUB (kidney, ureter, and bladder) and send me the result before the cystoscopy.

Patient's Query

Thank you doctor for the reply,

Can you look at my test strips given by my doctor? I constantly have blood in my urine. I do not believe this is IC. I have never had issues before. I am booked to see a specialist professor who treats embedded UTIs in two weeks. I also did an advanced PCR type of broth test this morning and sent it off. I hope I do not have an embedded UTI. Can you advise me on what you think of all that? Of course, blood also always shows up. Lately, I do not have many symptoms. My original symptom was frequency only. Then, I took the tablet Trimethoprim for five days. I do not know how I am going to manage to treat this. I have had relief lately because my symptoms tend to go. The blood in urine is always so strong. I thought it was improving. I have a burning sensation on the side near the rib and back on the right side, odd back aches, and sometimes the bladder area or pelvis has mild shooting pain. A doctor decided to offer me the tablet Nitrofurantoin so that I could tolerate all this. I took 100 mg initially because I was scared that it was an embedded UTI. My symptoms seem to get better. But there always seems to be some sensitivity or tenderness, which makes me aware of my bladder. I have not urinated often, but I drink more. Should I stop taking the medicines?

Hello,

Welcome back to icliniq.com.

Blood in the urine is not necessarily an infection. It has many causes, including infection, stone, inflammation, or kidney filter issues. Recommended investigations are urine culture for cytology and flexible cystoscopy bladder biopsy. Sometimes atypical infections can be there, which need another type of special culture. Now you have done urine analysis, and a culture ultrasound is required. If it is negative, then we need the flexible cystoscope and biopsy. CT (computed tomography) scan should be done accordingly.

Patient's Query

Thank you doctor for the reply,

I have some updates for you, so I will add some photos. My doctor thinks my culture is showing normal WBC and RBC count. He also says that everyone's report is like that. You told me that it was not normal and that I should have been on antibiotics. Sadly in my country, they only give us three to five days. Anyway, I need your advice. I recently did a much higher advanced culture which has proven that it is a UTI. My original culture report did not suggest anything. This urine test showed enterococcus species. It also says the original antibiotic to treat it is Trimethoprim. So why did my doctor say that it is sensitive? I think they still need to do tests.

So based on this information, I consulted a urologist. This urologist ultimately acknowledges embedded infection. Based on the report, he tells me that I should take the tablet Doxycycline because it is sensitive. Also, I had taken this before but had no side effects. I am allergic to penicillin. Would this be alright? My urologist tells me he wants me to take Doxycycline for four weeks in the morning and evening. I asked my urologist about the calcium oxalate crystals. He does not think I have got stones, but recently I've had some pain. So based on all this, do you think it is best to go with my treatment plan with a urologist? What will happen if I do not get the sensitivity report? I have been drinking freshly squeezed lemon in water to avoid further issues. Also, lately, sometimes I am having lower back pain. I am worried that the bacteria might be found in my vagina. Please let me know your thoughts on this and if this is the right track. My urologist told me that I should be alright even if I have an embedded UTI.

Hello,

Welcome back to icliniq.com.

From the attached images (attachments removed to protect the patient's identity), you have a vaginal infection, and it is sensitive to Doxycycline. You also have sterile pyuria, which means pus cells in urine without infection. The best way to treat the vaginal infection is to take tablets of Doxycycline and Azithromycin for two weeks, then repeat vaginal swabs and urinalysis. Consult a specialist doctor, discuss with them, and take medications with their consent. There might be a difference, as pus cells in the urine sample might be from the vagina.

Please follow up with reports after treatment so I can further advise you, and do not worry.

Kind regards

Patient's Query

Thank you doctor for the reply,

I truly appreciate it. I cannot take Azithromycin or Gentamicin as it causes ototoxicity. What worries me is that the Acinetobacter seems to be a superbug, and I am unsure how I got it. My first culture ever showed Coliform species, Klebsiella oxytoca, which only now shows vaginally. I am on day four of Doxycycline, but my ears are ringing more, and I have mouth ulcers. I have taken the tablet Nitrofurantoin. Do you think it is alright to change the tablets? Will it cause resistance after three days? I am still not seeing results. Can you advise me if I should use pessaries to kill bacteria? I recently had pelvic pain and am worried that the bacteria has spread to my reproductive organs.

Hello,

Welcome back to icliniq.com.

Do not worry.

I suggest you continue taking the tablet Doxycycline for five days. Yes, you can take vaginal pessaries because it is a good option. Lactobacillus can get destroyed with antibiotics, but they regrow later. To enhance that, I suggest you take probiotics like yogurt. There is no need to take Nitrofurantoin as it is bacteriostatic and not bacteriocidal, so it will stop bacteria for some time but will not kill them. Vaginal pessaries can be used for a week, and then repeat vaginal swabs after three days.

Kind regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Samer Sameer Juma Ali Altawil
Dr. Samer Sameer Juma Ali Altawil

Urology

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