Persistent UTI and Klebsiella: Seeking Guidance After Lack of Improvement on Antibiotics
Hello everyone, I’m a 32-year-old female who has dealt with urinary tract infections (UTIs) throughout my life, averaging between six to ten episodes annually. Typically, I manage them by increasing my fluid intake and using cranberry supplements, resorting to antibiotics like Monurol or fosfomycin only for the more resilient cases, usually around four or five times each year. However, my current experience has been quite troubling. I have been suffering from a UTI for approximately one and a half months now. Initially, I took three doses of Monurol, one each day, yet for the first time, I saw no improvement. Following this, a pharmacy test confirmed my situation, leading to the issuance of another antibiotic, which I believe was nitrofurantoin, although I am not entirely certain. Unfortunately, there’s been no change in my condition. In my next steps, I consulted a urologist who performed an ultrasound of my kidneys and bladder around two weeks ago. The results were normal, and subsequent urine culture tests identified Klebsiella pneumoniae as the culprit. The culture results indicated that the strain was sensitive to Cefuroxime Axetil, prompting a prescription of 500mg to be taken twice daily for ten days. I began this treatment on Monday morning, making today my fifth dose (Day 3.5). Despite this treatment, my symptoms persist unchanged; there’s no deterioration, no fever or back pain, just a constant discomfort from the UTI and persistent urgency to urinate. Interestingly, I've noticed a new pain that arises just before or as I start to urinate, contrasting with my previous experience where the greater discomfort was felt towards the end of urination. Here are the complete sensitivity results for the bacteria: - **Klebsiella pneumoniae** Amoxicillin-clavulanic acid: Sensitive Cefuroxime axetil: Sensitive Cefixime: Sensitive Cefoxitin: Sensitive Ceftazidime: Sensitive Ceftriaxone: Sensitive Cefepime: Sensitive Ertapenem: Sensitive Imipenem: Sensitive Meropenem: Sensitive Amikacin: Sensitive Gentamicin: Sensitive Tobramycin: Sensitive Ciprofloxacin: Sensitive Levofloxacin: Sensitive Tigecycline: Sensitive Nitrofurantoin: Intermediate Fosfomycin: Resistant Colistin: Sensitive Trimethoprim-sulfamethoxazole: Sensitive I would greatly value any thoughts from healthcare professionals or others who have faced similar situations. I’m feeling quite anxious about what might be unfolding here. What could be happening? What steps should I consider next? Thank you so much for your help!
Answers (1)
4/3/2025, 10:40:42 PM
OpenHealth AI
I'm sorry to hear about your persistent UTI and the challenges you're facing. Your situation is understandably frustrating, especially given your history of recurrent UTIs. Here’s a summary of what's going on and some actionable steps you can consider.
Main Points:
- You have a persistent UTI caused by Klebsiella pneumoniae, and despite recent antibiotic treatments, your symptoms haven't improved.
- A significant symptom change indicates pain before urination, which is worth noting.
Explanation:
Klebsiella infections can sometimes be tricky to treat due to antibiotic resistance issues. In your case, since the bacteria are sensitive to multiple antibiotics, it’s especially concerning that symptoms persist despite the prescribed treatment of Cefuroxime Axetil.
The new pain you’re describing when you begin to urinate may indicate irritation or inflammation of the urinary tract. It's important to monitor this and understand your options for further management.
Next Steps:
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Continue the Current Antibiotic: Finish the full course of Cefuroxime Axetil as prescribed, and monitor for any changes.
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Keep Detailed Symptom Tracking: Note any changes in your symptoms including intensity of pain, frequency of urination, or any new symptoms. This will help your healthcare provider in making decisions about your care.
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Hydration and Dietary Modifications: Increase your fluid intake to help flush out bacteria. Consider avoiding irritants like caffeine, alcohol, spicy foods, and artificial sweeteners, which could exacerbate symptoms.
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Discuss Pain Management: Over-the-counter pain relief, such as NSAIDs (like ibuprofen), can help manage discomfort during urination. Consult your pharmacist or healthcare provider for recommendations that are suitable for your situation.
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Follow-Up with Your Urologist: Since you’re not seeing improvement after a few days into the new antibiotic, reaching out to your urologist is crucial. Discuss your ongoing symptoms and the recent changes. They may consider:
- A repeat urine culture to check for persistent infection or other pathogens.
- Other diagnostic tests to evaluate for possible urinary tract abnormalities or persistent infection.
- Alternative antibiotic treatments based on your sensitivity results.
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Consider a Referral for Further Investigation: If the problem continues, your urologist may suggest seeing a specialist who focuses on recurrent UTIs or consider performing a cystoscopy, which allows direct visualization of the bladder and urethra.
Conclusion:
Your concerns are valid, and it's good that you are actively seeking solutions. By tracking your symptoms, managing your hydration and diet, and maintaining communication with your urologist, you can take meaningful steps towards improving your condition. Remember that you are not alone in this, and reaching out for further support is important if symptoms persist.
Feel free to share any further updates or questions!
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