How is an ESBL-positive UTI treated?

Question

Hi doctor,

I have spent three weeks struggling with a UTI. I urge to urinate every four to six minutes, and E. coli growth that has been resistant to four antibiotics. I had a low-grade fever that has recently dissipated.

I am completely debilitated and cannot function. My urine culture test is positive for EBSL.

Please advise.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

ESBL (Extended-spectrum beta-lactamases) E. coli (Escherichia coli) is a bad infection and needs treatment with antibiotics and further investigations to find any possible underlying cause. Causes can be stones or blockage to the urinary system, or pyelonephritis (infection of the renal cortex), which happens in diabetes or reduces immunity due to other systemic diseases.

Issues with the lower urinary tract lead to incomplete emptying of the bladder and cause infections (secondary to injury to the back or surgery previously done to the pelvis), ascending from the vagina or stool, and bladder fibrosis is challenging to treat.

Suppose the above problems do not cause it. In that case, it is an uncomplicated UTI (urinary tract infection) and will be treated by two weeks of oral Ciprofloxacin, as your culture is sensitive to that. Investigations required will be a KUB ultrasound and a post-void bladder scan.

The treatment plan includes adequate hydration, drinking fresh cranberry juice, and eating yogurt. Take Ciprofloxacin 500 mg twice daily for two weeks. Repeat urine analysis and culture after 72 hours of starting the antibiotics.

Follow up with ultrasound and repeat culture result, and update if you got DM (Diabetes mellitus) or radiotherapy, or even lower urinary tract issues leads to nerve control problems in your bladder.

If you have any more queries, please do not hesitate to ask.

Kind regards.