Any medics around? UTI urinalysis query

[ItsOoooon]

I came down with uti symptoms yesterday and started antibiotics last night as I always have some in the cupboard. My urinalysis sticks were out of date so I didn’t have any to test my sample. I didn’t think to keep any urine, but ordered more sticks.

I’ve taken 2 tablets (100mg nitro) and feeling no better which is unusual for me so I was worried that I don’t have a uti at all and maybe it’s thrush (as also feeling a bit tingly in the vagina area)

I have just dipped my urine and it’s negative except for blood. So leukocytes and nitrates are negative when reading at the appropriate time. The stick dries down to positive for leukocytes though but it’s outside the 90-120 second time period. It also dries down speckled rather than a solid colour (like non-haem RBC) which I’ve never seen before.

does this mean I don’t have a uti, or that I do but the antibiotics are working?

yesterday urine was cloudy with bits floating in it, today it’s clear but bright yellow thanks to the nitro.

as I say there’s no symptom improvement, I’m still really uncomfortable and was planning on using a canesten pessary this evening as I’d kind of told myself it couldn’t be a uti as antibiotics aren’t doing anything and usually I get some kind of relief within hours of my first dose. I literally want to rip out my bladder and remove my vulva at the moment 😩 and going on a work course first thing tomorrow morning and feeling utterly miserable

Why randomly commence antibiotics without getting a proper diagnosis? This is one of the reasons antibiotic resistance is becoming endemic. You could have popped into a pharmacy and they would have ensured you had a UTI and given appropriate antibiotics. ETA: or advised you on an appropriate course of action if ABx not appropriate.

It sounds like you may have a physical kidney problem, such as a stone, if there is blood in the urine. Go to a pharmacy or speak to a GP.

And FGS return the ABx to the pharmacy for appropriate disposal.

@HateHorridHenry the antibiotics were prescribed to me by my GP because I have frequent UTIs and need them on standby for situations such as this, which is a bank holiday weekend and my GP surgery and local pharmacies are closed.

the documented use clearly states to take at onset of symptoms, and says nothing about urinalysis, that’s something I choose to do to be thorough. Given my symptoms 111 would have prescribed antibiotics over the phone without testing urine also so take yourself off of your high horse.

clearly you know nothing about UTI’s so thank you for the bump, hopefully someone who does know will be along soon.

@HateHorridHenrythat was a pretty horrific way to come back, wasnt it? Hope you sleep peacefully behind your keyboard tonight, warrior!

@ItsOoooonno idea sorry but couldnt read that response and not reply - get better soon xx

@ButterflySkies 💕

You asked for opinions from people with some medical knowledge… can’t really blame me for giving you a stock answer if you’re going to drip-feed the Hx of complex UTI.

To be fair to @HateHorridHenry it did sound like @ItsOoooon was saying she always has some Antibiotics in the cupboard as a 'random stash' affair, rather than GP prescribed.

@ItsOoooon I think it's hard to tell with out of date dipsticks. Now you've started the course you need to continue anyway, or you'll build up resistance.

If you are breastfeeding, or on certain types of oral contraception, or taking aromatase inhibitors, or in your 40s, this could be vaginal atrophy - which can happen when your natural oestrogen levels drop. The hormone decrease affects your urinary tract/bladder as well as the vagina. See your GP - if you do have VA, it won't get better and could get worse. If it is this condition, then you will need vaginal oestrogen.

Why are you talking about a complex uti like you have any idea what you’re talking about? Are you a medical professional? If so why not answer my actual question?

I do not have symptoms of a complex uti - which fyi are kidney pain, lower back pain, chills, fever. If I did I’d call 111.

blood in the urine is common with uncomplicated UTIs. I am not concerned about this. I am asking about the leukocytes and nitrates reading negative after 2 doses of antibiotics.

@Lougle how else do you get antibiotics if not prescribed by a doctor? apologies for not making myself clear in the OP.

these dipsticks aren’t out of date, I threw the old ones away. These are new, freshly opened this evening.

@ooohsopink thank you. Not pregnant, breastfeeding or over 40 x

Tbh if you have frequent UTIs I’m surprised you aren’t aware how useless dipsticks are at picking up infection. Can you take the canesten when on antibiotics? If so do that. Otherwise continue the AB. Do you usually have a 3 or 7 day course?

Do you use d mannose or hiprex? Both worth considering long term if not (with high dose vit c if hiprex)

The reason pharmacies have posters asking people to return antibiotics if they aren't needed is because people don't complete a course, then stash the remainder in their cupboard. Doctors sometimes prescribe antibiotics just in case "It's probably viral, but I'll prescribe you some antibiotics. If the fever/symptoms haven't started to improve in 3 days, take the antibiotics." You obviously have a complete course, prescribed in readiness, but it isn't the norm, so the assumption was that you had some antibiotics left from another treatment/not started.

Oh and also nitro never works for me, need trimethoprim but obviously that’s maybe different for you

@thaegumathteth dipsticks have always picked them up for me in the past, I wasn’t aware of any issues? It’s a 3 day course, so I’ve now had half (3 of the 6 pills).

I use d mannose but only after intercourse as that’s my usual trigger. Not this time!

nitro has always worked in the past, I’ve never had trim.

@Lougle ah that makes sense. My GP is very good and doesn’t prescribe antibiotics unless necessary. I always finish my course - I have health anxiety so the thought of having antibiotic resistance terrifies me! I hate how often I need to take the buggers, every time I get a uti I worry that this one will be resistant / will turn into a chronic embedded uti.

Recurrent UTIs are considered complex UTIs. I am not a doctor but I do have some medical knowledge of UTIs and antibiotic stewardship.

With regard to your question, the results are invalid as read outside of the time limit. Therefore no one can advise you whether or not it’s because of the ABx use.

Yeah urinalysis sticks are basically not that great. They are better though at ruling out infection than the opposite. Does anything ever grow in the lab?

Have you tried Hiprex? It’s a game changer.

Thank you for explaining this so eloquently. I’ve also heard tales of people buying ABx abroad (Egypt for example) and bringing them back to the UK

I am in a similar position with frequent UTIs and always have antibiotics to hand to cover the weekend scenario. I have though recently seen a homeopathic expert and am having some success with whats been prescribed. Worth a try (have also noted hiprex).

@thaegumathteth yes, positive for e-coli usually but not often sent off (usually just self test and treat, I only go in if I don’t have antibiotics on standby like if I have 2 close together). Last appointment there was talk of prophylaxis but I don’t like taking antibiotics as it is let alone ‘just in case’. I’ve never heard of it, I’ll look it up!

@HateHorridHenry ive never heard of a recurrent uti be called a complex uti before, that’s interesting.

how about when it is read within the time limit? Which is negative except for RBCs.

I don’t know @ItsOoooon sorry. Hope you feel better soon.

Impossible to say now you've started to partially treat an unknown entity, hence why we don't advise self medication in a world of antibiotic resistance

You aren't going to get symptom relief from one dose, we advise 48h to start to notice an improvement

Call in sick, go see your gp (not my forte I'm now an anaesthetist but that's from my medical days knowledge

If you’re getting frequent UTIs you should ask for a urology referral and hiprex prescription

Why else would she have stock in her cupboard? It doesn’t take a genius

Dipsticks are useless. You may have become resistant to nitrofurantoin or the bacteria causing the infection may be different to the usual bacteria. You might need different antibiotics. In my experience it's a matter of trial and error with them.