Repeated urine infections

[Greentime101]

My elderly mother has had 2nd urine infections in 2 months both have caused her to fall so that was 2 ambulances, she broke a bone the first time so that was 3 weeks in hospital etc etc

This time we are on day 2 of trying to get the requested antibiotics from the GP, yesterday she spent almost 2 hours on the phone for the Dr to prescribe her “new” ones I did the 1.5 hour round trip to collect from chemist and take to mum who then vomitted them all back up - this happens with most antibiotics hence her asking for specific ones. So today another hour on the home & her neighbour has done the 45 min round trip to the chemist

The only thing I can think to break this cycle of doom is to purchase urine testing strips from Amazon & she tests every day - if she gets positive she starts antibiotics she has already been given? Any other bright ideas? Apparently pharmacists can’t dole out antibiotics to over 70s what a shame.

Thank you @Mothership4two

Cranberry isn’t a myth. It’s commonly recommended by doctors. I have had a uti after sex every single time I haven’t had cranberry juice/tablet afterwards. I’m not young and I’m not a nun so that’s a lot of times. It doesn’t cure an existing uti.

Another vote for vaginal oestrogen. If your mum is scared of falling she’s not going to drink lots, or if she does then 10 to 1 she will fall. It drives me nuts that HCP still bang on about lots of fluids to prevent UTIs in women with poor mobility rather than thinking about the consequences of vaginal atrophy.

I had VO prescribed specifically to sort my UTIs and it worked brilliantly.

Re drinking enough (many older people don’t) in my mother’s care home (specialist dementia) hardly any of them (inc. my DM) would ever drink plain water, so they gave them small glasses of fairly weak squash, orange or blackcurrant) several times a day.

Food was often fairly ‘watery’, too - soup, stewed fruit with custard, etc.

DM's GP has been prescribing her a daily low dose of antibiotics (I think trimethoprim) for years. DM has an indwelling catheter and very easily gets urine infections otherwise.

I suspect this may not be good precribing practice, but it keeps DM on the road.

<shudder> Yet another reason to dread a care home. Weak squash is an abomination.

Think my marbles must be going. It’s taken me till this post to realise there’s now a “quote” button. I spent all yesterday hitting tge three dots and looking bewildered.

Actually I've just been having a quick google and it looks as though prevention of recurrent UTIs by using daily antibiotics is absolutely a thing according to NICE guidelines (not just for people with catheters, but for adults with recurrent UTIs in general). Other methods, including some of those mentioned on this thread, are recommended for trying first, but if they're not effective then prophylactic antibiotics can be used in the long term.

I googled "NICE UTI prophylaxis" and similar phrases.

So it may be worth pursuing this with GPs etc.

I was on prophylactic antibiotics for a year before a gynaecologist suggested swopping me to oestrogen cream. The cream is far more effective and I’m not contributing to the massive problem of antibiotic overload and resistance any more.

Yes, from a quick google it looks as though oestrogen is one of the things that they're supposed to try BEFORE going to prophylactic antibiotics. So I'm quite surprised they gave you antibiotics first! Especially with the antibiotic resistance nightmare. I just shudder to think what new strains of bacteria DM is going to be responsible for. Prophylactic antibiotics seem to be the last resort, but they are there if nothing else works.

At least most of them drank it. Anyone who preferred water could have it, only I don’t recall that anyone did.

I used to get cystitis on and off, and almost always found that the sachets you can buy almost anywhere in the U.K. would see it off quickly, if I started them straight away.
The one time I couldn’t get them (on holiday in Cyprus) it persisted and got worse, so for the first time I ended up with ABs from the GP once home.

Nowadays I don’t go anywhere without my emergency supply - I always have some handy.

The high strength cranberry tablets from Amazon have been an absolute godsend for me. I used to get UTIs atleast 5 times a year and since I've been taking 1 a day I've had nothing for 3 years. Normal cranberry juice was useless however.

This ^ Older women are suffering terribly with urine infections owing to lack of hormones in the vagina. Ovestin cream can solve this. X

My mum was on a permanent low dose of Nitrofurantoin which is specifically for UTI. The infections stopped so it definitely worked.

It's a myth about cranberry.. Zoe Williams the Dr on This Morning was only talking about this the other day.
She suggested D Manose.
Worth a try.

No advice but empathy. Is your mum continent? If not, is this causing her not to drink enough?
Same issue for poor MIL. Doubly incontinent, hates it, doesn’t drink as a result, hence infections. It’s a vicious circle.

@GreeGreentime101 I had similar with my late DM, including the weekly pharmacy delivery. Eventually, the GP prescribed a set of antibiotics that she kept in the cupboard 'just in case'. It still meant a call to the out of hours GP or ambulance when she was getting in a pickle, but the tablets were there ready to go.

thismorningitv.page.link/GQZ28XwvnCLC69kh8

I've put the link up.

Possibly depends on whether you’re post menopausal. Vaginal atrophy is a result of the cutting off of the oestrogen supply, so if you’re pre menopausal and well lubricated, there’s possibly no point in trying the oestrogen cream first.

Oh thank you for all your posts - really really useful - we need to visit her Drs and make a plan.

Plus that link saying in the last 5 years there have been 1.8 mill hospital admissions from UTIs - wow

Studies show cranberry is effective though
https://www1.racgp.org.au/newsgp/clinical/cranberry-juice-can-prevent-some-recurrent-utis-co#:~:text=Cranberry%20products%20reduce%20the%20risk,interventions%20(by%20about%2053%25).

My mother had cystitis/UTIs on and off for decades and was repeatedly on antibiotics. If I had known then what I have been reading about recently, I would definitely have urged her to ask the GP about vaginal oestrogen.

As it turned out, the final, intractable months-long 'UTI', which was always diagnosed over the phone, and never responded to antibiotics, was actually bladder cancer.

@Greentime101
My DM had regular UTIs followed by a course of antibiotics. Her GP prescribed a nightly Trimethoprim a year ago, she's had no more problems since she started them.

Interesting to read this as I'm shortly off to hospital to visit my DM (81) who is in with her 3rd bout of urosepsis since Christmas no doubt due to blocked catheter & lack of fluid. I'm hoping to meet the doctor today and speak to him/het about low dose daily antibiotic as they are talking about discharge in a few days and I'm worried they haven't got rid of the underlying infection and my mum buries her head in the sand and doesn't tell anyone until it's too late! We are really at the stage of needing bladder removal (consultant recommend but she is strongly resisting) but that isn't going to happen overnight and she is in terrible pain constantly and we're on high alert for repeat infections.

Really horrible condition that has changed a fit & active very young looking/feeling 79 year old into a withered little old lady who won't leave the house in little more than 18 months yet no one seems to have any answers. And of course undetected cancer is always on my mind