Tuesday, January 31, 2023

Best Antibiotic For Resistant Uti

What Is A Urinary Tract Infection

Ask Dr. Nandi: Antibiotic-resistant urinary tract infections are on the rise

UTIs are common infections that happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. The infections can affect several parts of the urinary tract, but the most common type is a bladder infection .

Kidney infection is another type of UTI. Theyre less common, but more serious than bladder infections.

What Do I Do If I Have A Question About Antibiotic

If your question is about your own health, please contact your GP or medical specialist treating you.

If you are feeling unwell but the problem is not a medical emergency, call 111 to find out whether you need to attend hospital.

If you are experiencing a health emergency, you should call 999 or attend your nearest accident and emergency, taking all of your medications with you.

If you are not seeking health advice, but would like to talk to someone who understands antibiotic resistance and can help you find more information, get in touch with our Patient Support Officer, Arlene.

Contact Arlene on or call her on 07367 784114. Calls are charged at your usual mobile or landline rate. However, you can request a call back from Arlene by text, email or by leaving a message.

First Line Antibiotics For A Uti

  • Ampicillin
  • Nitrofurantoin
  • Trimethoprim/sulfamethoxazole

Notably absent from the list of antibiotics prescribed for the treatment of UTIs is Amoxicillin. While very popular and useful in treating numerous other bacterial infections, urinary tract infections are not amongst the infections Amoxicillin is used for.

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Best Probiotics For Recurrent Utis

Using a special strand of probiotics was proven to restore the urogenital flora of healthy premenopausal women.

The Lactobacilli probiotic dominates most healthy womens urogenital flora, and many clinical studies show that its the most effective probiotic you can take to prevent recurring UTIs.

However:

Some strains are better than others. Here are the findings:

Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 seemed to be the most effective among the studied lactobacilli for the prevention of UTIs. L. casei shirota and L. crispatus CTV-05 have also shown efficacy in some studies

Where Can You Find This Exact Probiotic?

I recommend the Jarrow Formulas Fem-Dophilus, which supports vaginal and Urinary Tract health you can purchase it from iHerb.

It contains the right strain of probiotics proven to prevent UTIs $29 at iHerb

What about you? what has worked best for you? Share your experience in the comments below.

To your health and happiness,

Meital

If You Get An Infection Ask For A Culture

The Best Antibiotics to Treat a UTI

If you have something like a UTI or other infection where antibiotics are pretty much the only way youll get better, ask if its possible for your doctor to first do a culture of the specific bacteria causing your infection. Your doctor can then choose the antibiotics that will best kill that type of bacteria. Tailoring antibiotics in this way can also help treat your infection more quickly, Sokurenko says, since some bacteria are more resistant to the more general antibiotics doctors typically prescribe before a culture is done.

Read Also: Antibiotics For H Pylori Eradication

Can A Pregnant Woman Take An Antibiotic For Diarrhea

Antibiotics can cause severe diarrhea. If you have watery diarrhea two or three times or more per day for at least two days, or if you have stomach cramping, call your doctor right away. You may have a second infection that can be dangerous during pregnancy. Your doctor will prescribe another type of antibiotic for this issue.

Is it safe to take antibiotics during pregnancy? Heres a sampling of antibiotics generally considered safe during pregnancy: 1 Penicillins, including amoxicillin, ampicillin. 2 Cephalosporins, including cefaclor, cephalexin. 3 Erythromycin. 4 Clindamycin.

Alternative Therapeutic Options To Antibiotics For The Treatment Of Urinary Tract Infections

  • 1VBMI, INSERM U1047, Université de Montpellier, Service des Maladies Infectieuses et Tropicales, CHU Nîmes, Nîmes, France
  • 2VBMI, INSERM U1047, Université de Montpellier, Service de Microbiologie et Hygiène Hospitalière, CHU Nîmes, Nîmes, France
  • 3Service des Maladies Infectieuses, AP-HP Raymond-Poincaré, Garches, France
  • 4PRES Centre Val de Loire, Université François Rabelais de Tours, Tours, France
  • 5Service des Maladies Infectieuses, CHU Tours, Tours, France
  • 6Service dUrologie, CHU Tours, Tours, France

Read Also: What Probiotic To Take When On Antibiotics

Take Antibiotics As Directed

If youre prescribed antibiotics, take them exactly as your doctor tells you to. That means no skipping doses or using leftover pills months later. Follow your doctors instructions for how long to take the pills for: if youre supposed to take them for two weeks, take them for two weeks, even if you start feeling better sooner.

How Do Antibiotics Treat A Uti

UTIs and antibiotic resistance

UTIs can be caused by many different types of germs including bacteria or fungi and in rare cases, even viruses. But bacterial UTIs are the most common.

If you have a bacterial UTI, the only way to treat it is by getting rid of the bacteria thats causing it. Thats where antibiotics come in. They either stop those bacteria from growing or directly kill the bacteria altogether.

Its worth noting that antibiotics only treat UTIs and other infections caused by bacteria. If you have a fungal or viral UTI, antibiotics wont help.

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Antibiotic Overuse Leads To Antibiotic Resistance

At some point, most people have taken a course of trimethoprim/sulfamethoxazole or ciprofloxacin , two common antibiotics used for UTIs. However, in the last few years it has become clear that the likelihood these antibiotics will kill most UTIs is dropping rapidly. You may have read the recent, frightening New York Timesarticle reporting one in three uncomplicated UTIs in young healthy women are Bactrim-resistant and one in five are resistant to five other common antibiotics. Pretty scary, since we used to feel confident that writing a prescription for Bactrim was a sure recipe for cure.

How is it that we are losing the antibiotic war with bacteria? Though many things drive bacterial resistance, giving antibiotics to animals and antibiotic overuse in humans top the list.

We use a lot of antibiotics in humans too much, and not always for the right reasons. When we prescribe antibiotics for viral illnesses like a cold, the flu, or common sinusitis, we create a massive shift in the bodys bacteria for no good reason .

What Are The Symptoms Of An Antibiotic

You can find out more about the symptoms of a UTI on our common infections page. The main difference between a regular UTI and an antibiotic-resistant UTI is that the medicines usually used to treat such infections do not often work against antibiotic-resistant UTIs. While the antibiotics may appear to work at first, they are only killing those bacteria sensitive to the antibiotic, but not dealing with the resistant organisms. This means it is really important that if antibiotic resistant bacteria are present, they are diagnosed and identified as early as possible so the right antibiotics are used to kill them.

To identify if you have a UTI, your doctor will usually ask you to provide a urine sample which they will test with a dip stick. This is a quick way to establish if you have a urine infection. If positive, then a sample of your urine will normally be sent to the local microbiology laboratory for testing.

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How Do I Know If My Particular Strain Of Uti Is Resistant To A Particular Drug

The only way is to get a urine culture. The lab results will identify the germ and what would be effective in treating the infection. But it can take several days to get the results.

Most patients want an immediate prescription so doctors usually make a best-guess determination of what drug will work given a patients symptoms and history.

The importance of history cannot be overstated if you have had a previous U.T.I., a previous resistant U.T.I., or have traveled outside the country, your history can help a doctor decide which drug to use.

Increasingly, experts tell us that you should ask for a culture when you go in for a U.T.I. treatment, even if you get an immediate prescription. The culture will allow a doctor to change the drug if the first one does not work.

That said, there is an important catch about when to do a urine culture. Often, it will show bacteria in the bladder even when an infection is not present. Some amount of bacteria is normal. The Infection Disease Society of America cautions doctors against doing cultures when symptoms of a U.T.I. are not present. The culture likely presence of bacteria can then lead to prescription of unnecessary antibiotics, contributing to the rise of resistance through overuse of the drugs.

Finally, some U.T.I.s, even when there are symptoms, can clear up on their own. This is one of many reasons to seek the care of an informed professional.

The Common Symptoms Of Utis In Men That Antibiotics Actively Treat Are:

Antibiotics for Cats
  • Pain in the pelvic region
  • Burning sensation while passing urine
  • The frequent urge of peeing

So, whenever you face these symptoms just get in touch with a specialist doctor. The doctor will prescribe you antibiotics to treat the urinary infection. Lets know about some of the most effective antibiotics for UTIs in men.

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Treatment Strategies For Recurrent Utis

Recurrent urinary tract infections, defined as three or more UTIs within 12 months, or two or more occurrences within six months, is very common among women these but arent treated exactly the same as standalone UTIs. One of the reasons: Continued intermittent courses of antibiotics are associated with allergic reactions, organ toxicities, future infection with resistant organisms, and more.

Because of this, its strongly recommended that you receive both a urinalysis and urine culture from your healthcare provider prior to initiating treatment. Once the results are in, the American Urological Association suggests that healthcare professionals do the following:

  • Use first-line treatments. Nitrofurantoin, TMP-SMX, and fosfomycin are the initial go-tos. However, specific drug recommendations should be dependent on the local antibiogram. An antibiogram is a periodic summary of antimicrobial susceptibilities that helps track drug resistance trends.
  • Repeat testing. If UTI symptoms persist after antimicrobial therapy, clinicians should repeat the urinalysis, urine culture, and antibiotic susceptibility testing to help guide further management.
  • Try vaginal estrogen. For peri- and post-menopausal women with recurrent UTIs, vaginal estrogen therapy is recommended to reduce risk of future UTIs.

RELATED: The Link Between UTIs and Sex: Causes and How to Prevent Them

What Happens If Antibiotics Dont Work For A Uti

If youve taken antibiotics for UTI for several days and see no improvement with your UTI, there are two common possibilities:

  • The antibiotic may be ineffective at fighting off the bacteria causing your UTI.
  • Your infection may not be bacterial.

At this point you should contact your doctor to discuss a different treatment plan. It is likely that you will be referred to a lab for urine testing. Your urine sample will be checked for different types of bacteria, viruses, and fungi that could be causing your UTI.

Your lab results should be back within two to three days, at which point the doctor can give you a new treatment plan for your specific infection.

If your UTI does not go away or comes back soon after treatment, you are suffering from chronic UTIs.

For those that wish to treat their UTI without using antibiotics or who want extra relief while taking antibiotics, there are many natural remedies that can help your body fight off a UTI.

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Why Women Suffer From Utis

Did you know? UTIs are the second most common reason people visit their doctor every year.

And by people I mean usually women.

More than 8 million women head to their doctor for UTI treatment annually . And, 20 percent of them will get a second UTI .

Why?

1. Women have shorter urethras.

2. Men have a magic weapon against UTIs. Their prostate gland shoots a bacterial growth inhibitor directly into their urinary system.

Most Common Bacteria That Cause Utis

Dr. Michael Hsieh on Chronic UTI, Part 3: Antibiotic Resistance & How to Treat Complicated UTI

Based on a study by The National Center for Biotechnology Information, the bacteria most commonly associated with causing UTIs are:

  • Escherichia coli
  • Pseudomonas aeruginosa
  • Enterococci

Based on the symptoms the patient is experiencing and before any testing is done to officially determine the infection type, the doctor prescribes first line antibiotics. For most UTIs, the prescribed antibiotic will cure the infection and not require any further testing.

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Amoxicillin/potassium Clavulanate Cefdinir Or Cephalexin

How it Works: is another combination drug that belongs to the penicillin class of antibiotics. and belong to a different class of antibiotics thats closely related to penicillins.

All three antibiotics kill bacteria by destroying one of its most important components: the cell wall, which normally keeps bacteria structurally intact.

Common doses:

  • Amoxicillin/clavulanate: 500 twice a day for 5 to 7 days

  • Cefdinir: 300 mg twice a day for 5 to 7 days

  • Cephalexin: 250 mg to 500 mg every 6 hours for 7 days

Notable side effects: Diarrhea, nausea, vomiting, and rash are common side effects of these antibiotics. In rare cases, all three have the potential to cause the dangerous skin reactions, SJS and TEN.

If you have a penicillin allergy, your healthcare provider wont prescribe amoxicillin/clavulanate. They may or may not prescribe cefdinir or cephalexin since there is a small chance that a person with a penicillin allergy may also be allergic to these two.

What Happens When A Uti Goes Untreated

Thanks to early diagnosis and proper treatment, the vast majority of lower urinary tract infections result in no complications. However, if left untreated, a UTI can have serious ramifications notes the Mayo Clinic, including:

  • Recurrent UTIs
  • Premature birth and low birth weight
  • Kidney damage, which can occur is an untreated UTI spreads from the bladder to the kidneys.

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Superior Persistent Gut Colonizers

The study authors describe the two drug resistant strains of E.coli that they found as superior gut colonizers that tend to persist there.

They can also show up, they note, at an unusually high rate, in the urine of healthy women who did not have a documented urinary tract infection diagnosis at the time of sample testing.

Both phenomena appear to be interconnected, they add.

The findings could have a number of clinical implications concerning the care and control of infections, says senior study author Dr. Evgeni V. Sokurenko, a professor of microbiology at the University of Washington School of Medicine, in Seattle.

He suggests that testing for multidrug resistant bacteria in the gut could help doctors predict how strongly a womans infection might resist drug treatment.

It might also be necessary to have a policy about what doctors should do if they find resistant bacteria in the urine of patients who have no symptoms of infection.

Ridding carriers of widespread resistant strains could potentially reduce their risk of multidrug resistant infections, Dr. Sokurenko suggests. It could also reduce the risk of such infections in those with whom they come into contact.

Dr. Sokurenko is a major shareholder of ID Genomics, a company that specializes in matching a specific drug to the germ behind an infection. He has also applied for patents for tests that detect strains of E.coli.

Common Side Effects With Antibiotic Use

Antibiotic resistance: UTI, among top 10 causes of death ...

Each antibiotic is responsible for its own unique list of side effects, and the list is usually extensive. Be sure to discuss your individual antibiotic side effects with your healthcare provider. However, there are side effects that are common to most antibiotics, regardless of class or drug:

Related: Common Side Effects from Antibiotics, Allergies and Reactions

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How To Fight Drug

Sokurenkos work is further proof that researchers need to find ways to combat superbug E. coli and fast.

One area Sokurenko is interested in exploring is how to prevent healthy humans from being carriers for the bacteria.

We ourselves are this reservoir, we continuously carry them. We want to eliminate the reservoir of the bugs so they cannot cause us problems on their own, Sokurenko says.

There are several potential ways to go about this. Since the amounts of certain bacteria in the gut are constantly changing, learning more about what pushes drug-resistant E. coli out of the gut could help researchers replicate that process. Specially designed probiotics or certain foods might help clear the gut, Sokurenko says, as could viruses called bacteriophages that can infect and kill off bacteria.

His goal is to develop a comprehensive study and collaborate with other doctors, plus veterinarians and wildlife scientists, to learn more about how superbugs emerge, how they hide out in human bodies and how they circulate in our environment.

The bacteria have been here long before us they know how to survive, he says.

Can Uti Symptoms Linger After I Take Antibiotics

Since UTI symptoms usually improve just a few days after starting antibiotics, youll want to talk to your healthcare provider if you notice that UTI symptoms are still hanging around after finishing your antibiotics.

Theres no need to panic, but you and your healthcare provider will want to make sure the antibiotics actually worked against your UTI. To do this, they may take another sample of your urine to see if the bacteria are still there or not. If the infection is cured, youll want to be sure there isnt a different issue thats causing similar symptoms.

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Small Compounds Targeting Urease

Urease, an enzyme which catalyzes the hydrolysis of urea, is crucial in the pathogenesis of several uropathogenic bacteria such as P. mirabilis, Klebsiella sp., Pseudomonas sp. and Staphylococcus sp. . This enzyme leads to the alkalinization of the urine and the production of struvite and carbonate apatite that make up the major component of urinary stones . These conditions lead to the inflammation of the urogenital epithelia thus increasing the risk of catheter-associated biofilm formation that may contribute to pyelonephritis , mainly due to both bacterial and host cysteine protease .

The most studied inhibitors of urease are hydroxamic acids . These molecules have a high inhibitory activity against urease, by bonding to the two nickel ions in the urease active site . Initially, these molecules were used to treat UTIs by preventing urine alkalization . However, because of the growing evidence of side effects such as mutagenic power, they were progressively phased out .

Through similarly interacting with nickel ions in the urease active site, the phenyl phosphoramidates were found to have the highest inhibitory activity . Studies testing these molecules in an in vitro model and in a rat model found promising results. Since then, no in vivo studies or clinical trials have been developed, probably due to the poor hydrolytic stability of these molecules which leads to a very short half-life .

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