Considering Antibiotics for Asymptomatic UTI with Enterococcus Faecalis
A 32-year-old female with a medical history of frequent premature ventricular contractions and generalized anxiety disorder has been taking 5 mg of Lexapro. During her recent annual check-up, she mentioned to her physician that she observed a strong odor in her urine, though she did not report any other symptoms. Following this, a urine culture revealed the presence of Enterococcus faecalis, leading to a prescription for Augmentin. Given that she is asymptomatic, she is questioning the need for antibiotic treatment. She has a strong aversion to medication and experiences heightened anxiety regarding it. Additionally, she is concerned about the increasing problem of bacterial resistance and wonders if the presence of this particular strain necessitates treatment. Thank you for considering her inquiry.
Answers (1)
6/23/2025, 10:10:31 PM
OpenHealth AI
It’s understandable to feel anxious about taking antibiotics, especially when they are prescribed without any symptoms of infection. Here's a breakdown of your situation regarding the presence of Enterococcus faecalis in your urine:
Key Points:
- Asymptomatic UTIs: Many people can have bacteria in their urine without any symptoms (asymptomatic bacteriuria), and treatment is not always necessary.
- Enterococcus faecalis: This specific bacterium can be present without causing an infection, especially if you're not experiencing typical UTI symptoms like pain, burning, or frequent urination.
- Antibiotics and Resistance: Your concern about antibiotic resistance is valid, as unnecessary use of antibiotics can contribute to this growing issue.
Explanation:
In a healthy individual, a positive urine culture for Enterococcus faecalis without symptoms does not typically warrant treatment with antibiotics. The guidelines from organizations like the Infectious Diseases Society of America suggest that treatment is usually reserved for individuals who are symptomatic or at high risk for complications. It's great that you are considering these factors, as the over-prescription of antibiotics can lead to resistance and diminish their effectiveness in the future.
Next Steps:
-
Re-evaluate Need for Treatment: Given that you have no symptoms, consider discussing with your physician the possibility of delaying antibiotic therapy. You can express your concerns about your current medication, side effects, and resistance.
-
Monitor Symptoms: Keep a diary for any possible new symptoms over the next few weeks. If you notice any signs of infection or feel unwell, report this before making a decision on treatment.
-
Hydration and Diet: Maintain good hydration, which can help flush out the urinary system. Eating a balanced diet rich in fruits and vegetables can support your overall health.
-
Addressing Anxiety: If your anxiety about medication is heightened, consider discussing this openly with your healthcare provider. There may be alternative strategies or treatments to address both your worries and any potential infection without immediate use of antibiotics.
It's important you feel comfortable with your treatment plan, so communicate actively with your healthcare provider about your concerns. If you have more questions or need clarification, don’t hesitate to ask!
Related Questions
Understanding Prolapsed Appendix in Young Adults
Hello all, I’m a 25-year-old woman who has been struggling with persistent abdominal discomfort, along with nausea and diarrhea, for more than a decade. A recent colonoscopy has diagnosed me with a prolapsed appendix, despite the fact that my colon appears unaffected. Biopsy samples were collected to investigate potential inflammation, and I am currently awaiting those results. Additionally, I have a balloon enteroscopy scheduled to examine my small intestine more closely. From my research, it seems that appendiceal prolapse or intussusception is quite uncommon in adults. I am particularly interested in understanding how rare this issue truly is, especially for someone at my age, along with the typical causes that could lead to this condition. I have a few queries: How uncommon is a prolapsed appendix in adult patients? What are the most frequent causes linked to young women like myself? Are there specific risk factors or trends that might increase the likelihood of developing this issue? I’m not seeking a personal assessment, but I would be grateful for any information from those who are familiar with the occurrence and causes of this condition.
Did I Experience a Seizure Upon Waking?
This morning, I had an awakening that was unlike anything I’ve felt before. As a 23-year-old man, I’m familiar with sleep paralysis, often waking up immobile; however, today was distinct. I found myself in a state that resembled paralysis but accompanied by rapid, shallow breaths, akin to hyperventilation—something I don’t typically experience, even during strenuous activities. My body was trembling, reminiscent of numbness from cold or perhaps involuntary contractions throughout. Additionally, I felt a strange pressure on my groin, coupled with discomfort in my right testicle, as if they were being retracted into my body. I don’t regularly take medication aside from using an albuterol inhaler during asthma flare-ups. Standing at 6 feet 4 inches tall and weighing approximately 210 pounds, I also had a particularly unsettling dream just prior to waking, which might explain my reaction (at least, I hope it does). However, I can’t shake the anxiety that this could have been a type of seizure and I’m eager for input from those who have more expertise on the subject.
Identifying Skin Marks on My Child
My 5-year-old daughter, who has no history of allergies, has developed peculiar skin marks over the past four to five days. Each morning, I observe these blemishes, which mysteriously disappear by the next day, only to reappear in different locations. The majority of these spots are located on her lower back, buttocks, and the back of her thighs, although I've also seen some on her upper back and a single one on her cheek. As an additional note, she began exhibiting mild cold symptoms last night, including a cough, some mucus, and a slight increase in body temperature. To provide further context: she mentioned that the marks are somewhat itchy, but she hasn’t been scratching them excessively.
Impact of Tegretol Overdose at Age 7
As a woman now in her late thirties, I reflect back on a significant event from my childhood. At just seven years old, I accidentally ingested a large quantity of Tegretol, a medication prescribed to my brother for his epilepsy. Without realizing the danger, I swallowed a handful of those pills and fell asleep on the couch next to my mother. To my surprise, I regained consciousness a week later in a hospital bed. My mother recounted that I had suffered a seizure, at which point she found herself unable to awaken me, leading to a state of coma. Once I awoke, the emotional shift was profound; I transitioned from sadness to experiencing a tumultuous range of feelings. I am now curious about how such an overdose could have impacted my brain function. I attempted to search online for insights but came up empty-handed. Any information or shared experiences related to brain effects from similar situations would be greatly appreciated. Thank you in advance!
Unexplained Symptoms Over the Past Few Years
Greetings, Around three years ago, I started to experience a variety of symptoms that appeared quite abruptly. They seemed to improve briefly, only to return later. This initial onset threw me into a panic, leading me to suspect something severe, like cancer. After consulting my physician, I underwent tests through a neurologist and had multiple lab analyses, yet no definitive diagnosis emerged. Frustrated by the ongoing uncertainty, I ceased my attempts to find answers and have not revisited the doctor for these issues in years. This situation dates back to approximately 2021, coinciding with my time as a nursing student. While I can't be sure if there's a connection, it was around this period that I contracted COVID-19 for the first time and also received my annual flu shot as part of my nursing curriculum. Additionally, I was treated for melanoma during this time, undergoing a Mohs procedure to eliminate it, which was part of the initial anxiety surrounding my symptoms. Below are the symptoms I’ve documented: The first change I noticed was an unrelenting muscle fatigue. Simple tasks such as carrying groceries or working outdoors left me feeling immensely winded. I began to realize that the muscles in my neck felt excessively weak, and my arms and legs, although still functional, felt distinctly weaker than before. Although I could still perform my usual activities, I often felt unsteady, especially when descending stairs. Shortly thereafter, I began suffering from frequent muscle cramps at night and persistent twitching in my muscles during the day, particularly in my legs. I also observed involuntary movements in the inner arches of my feet, which, while somewhat common, were consistently present and unusual for me. Another concerning symptom was the onset of intermittent blurred vision. This issue varies in intensity, making it particularly troublesome during episodes that seem to flare up, often exacerbated by bright lighting, like that from screens or sunlight streaming through open windows. I found myself increasing the font size on screens and printed material because reading became quite challenging. While I haven’t seen an eye care professional yet, the suddenness of these vision problems caught me off guard. Additionally, I observed a significant size disparity between the muscles in my arms; my left arm appeared noticeably bulkier than my right. As a left-handed individual, I had never paid much attention to this before, though it’s possible it’s been like this for some time. The most perplexing symptom, one that’s been difficult to research, involves my right shoulder area. The deltoid region developed an odd squishy sensation. This prompts me to mention the flu and COVID-19 vaccinations. I’ve found no information on this symptom, and inquiries yield little guidance. Initially, it felt as if a lump had developed beneath my deltoid. Gradually, the entire area became squishy, resembling fibrous, lumpy tissue rather than muscle. In contrast, when I flex my left arm, it feels muscular and firm, whereas the right arm feels substantially softer. This strange condition raises questions—could a flaw in the vaccine administration by classmate healthcare students have contributed to this issue, or is it related to my other unexplained symptoms? As for medical evaluations, my Basic Metabolic Panel and Magnesium levels were unremarkable, as was my Complete Blood Count. Further inflammatory markers including CRP, CK, and ESR all returned normal results. My hemoglobin A1c was towards the high end of normal but did not classify as pre-diabetic. Autoimmune tests yielded no significant findings, and a nerve conduction study did not reveal any abnormal results either. The results from an EMG suggested mild increased insertional activity in several tested muscles, though it was deemed possibly normal, yet it might indicate an EMG disease. Unfortunately, I was unable to undergo MRI imaging due to insurance challenges at that time. I am a 42-year-old male with no significant past medical history beyond the prior melanoma and not currently using medication, aside from over-the-counter Benadryl for sleep issues. Apologies for the detailed narrative, but I felt this could be a valuable forum for seeking perspectives. I appreciate your time. It’s important to clarify that I am not prone to hypochondria; prior to these developments, I rarely sought medical care and, oddly enough, didn’t even have a primary care provider when these symptoms began.