Nitrofuratoin / antibiotic resistance worries

[Wmoejg]

Hi, I was diagnosed with a uti 3 days ago and prescribed a weeks course of nitrofuratoin for my symptoms. I had blood in my urine at the time and the dip stick seemed to think it was quite bad but hadn't spread to kidneys.
Initially I felt a lot better even though my wee was literally luminous highlighter yellow (almost green!). However on day 4 now and feel like some pelvic pressure is returning. I've read about antibiotic resistance and then urosepsis and now I've got myself in a right worry about what antibiotic resistant UTI's are like and what might happen.
Any advice or ideas?

FYI no temp or tachycardia

I’ve been on daily cefalexin for 30 years due to recurrent UTIs and interstitial cystitis. They occasionally switch me to trimethoprim or clarithromycin if I have a particularly stubborn flare (I generally take one cefalexin a day and up to 3 a day if necessary). I am under a urologist and have been since I was 14 (now 43). You won’t get antibiotic resistance after 3/4 days. You may just need another antibiotic. The nitro never works for me personally. Ring 111 for advice.

Hi thank you for your reply.
my actual infection symptoms started on the 26th so will be on my 5th day of the actual infection. This course of antibiotics ends next week - so I contact 111/ the gp today or wait until the course is complete before I try and make a switch to another antibiotic. I think I’m just scared as I’ve never had an antibiotic not work before. I’m sorry you’ve struggled for so long. This is my 3rd this year and I’m already so upset about it.

best wishes and happy new year x

It may be that you just need a longer course or a different antibiotic to get rid of it properly - but 3 a year isn’t a lot actually, even though it seems like a lot for you personally. There are all sorts of different types of bacteria that cause UTIs, it doesn’t necessarily mean you’ve got antibiotic resistance because you need a different one - it might literally just be the antibiotic is the wrong type for the uti. Definitely contact 111.

Also - not sure how old you are but declining oestrogen plays a part in the increase of utis as we get older. If you’re mid 30s onwards it’s likely this could be part of it (no blood test is reliable in detecting oestrogen levels in peri menopausal women as they fluctuate so greatly) but if you’re wanting to try some internal oestrogen cream (Ovestin) it might be worth asking your GP to prescribe some as it can really reduce the amount of UTIs you get.

Agree vaginal oestrogen is important but also look at Hiprex. Game changer- very rarely need antibiotics now.

https://evidence.nihr.ac.uk/alert/methenamine-as-good-as-antibiotics-preventing-urinary-tract-infections/

Whatever happens, you need to complete the course. I had a kidney infection just before Christmas and that's what the doctor told me, even if I needed another kind of antibiotic as well.

@Pigeonqueen thank you for all your knowledge on the topic, it's helped me deescalate the panic! 111 have advised I speak to my GP when it's open tomorrow, but if gets worse I can always access an urgent treatment centre. I was on this antibiotic when I last had a uti (1 month ago) and think possibly there was some residual bacteria left over which may be why this antibiotic isn't working anymore. Hopefully the next clears it x

@Pigeonqueen also I'm 25 but my hormones are (and have always been) all over the place. I get cystic acne, irregular periods, excess hair growth, hair loss etc. So do wonder if my hormones play a part.

The only other change which seems to have correlated is I had the copper coil fitted 2 months ago and ever since have had a few UTI's. Wonder if that could somehow be having an impact?

I was in a similar position to you , taking daily abx for years , until I spoke to a nutritionist for advice on an unrelated matter.She was shocked that no urologist had suggested this but she suggested cutting all sugar completely for six weeks and then sticking to a low sugar diet. Within two days I had lost that constant,vaguely agitated feeling and I stopped the nitrofurantoin and haven’t had an attack since - it’s been 3 yrs now and has changed my life!

@HalfasleepChrisintheMorning thank you for the info. I just said to another commenter that although young I've always had hormonal issues - cystic acne, hair loss, excess hair growth (chin, neck, chest etc) so my hormones have always been a bit funky. I do wonder if that could be a missing piece?

I have always been prone to UTIs, nitro doesn’t seem to work for me now, but thankfully Cefalex does.

@mynameiscalypso I will do that! Thank you :)

@Palepinkish wow!!!! Amazing. What's your diet like now re sugar? X

@NearlyMonday I'm so glad you've found something that works! It seems a few people don't get on too well with nitro x

Being a pedant, (aka retired pharmacist) nitrofurantoin is not an antibiotic but a urinary antiseptic. Some have argued it should be treatment of choice in UTI. If it hasn’t worked you need back to the GP. There maybe something in looking at oestrogen levels, depending on your age.

Oddly as I write I am waiting for an ambulance for my DH who has had a UTI for three months, seven courses of antibiotics and not got any better at all. It's affecting his vascular dementia (already fairly severe) very badly indeed and I phoned 111 to ask for help about it. The clinician who phoned me back is worried about urosepsis and has sent an ambulance which will arrive in a couple of hours.

I think the incidence of resistance to antibiotics must be rising quite high now generally but I do wonder how ill one has to be before they prescribe one of the new superdrugs.

Just realised this is on the Womens Health board - apologies, cos DH is male.

@Daisymay2 my GP is closed today but I'll try them tomorrow. Do you think there's any urgency in speaking to a GP today?

I was on Nitrofurantoin for 8 weeks on and off a couple of years ago, it just wouldn't shift my UTI. In the end a 4 week low dose course of cefalexin finally got rid of it.

@FlipFlops4Me I really hope your DH feels better soon. 3 months is a long slog. Hopefully they can find the right treatment that works for him today and refer to urology? Best wishes, he will be okay :)

Also recommend trying a high strength cranberry supplement - I used to suffer all the time but have been so much better since I started taking it!

@mummyh2016 I'm so glad I'm not alone in this. I'm also glad there was an antibiotic to help you finally!!! They're horrible infections. X

@InAMess2023 I've ordered some from Holland and Barrett. Any specific ones you recommend? I also ordered D Mannose after seeing it recommended x

@Wmoejg the ones I get a Prowise Cranberry with Vitamin C, I got them from Amazon but to be honest haven't tried any other brands as they seem to work! Although I should add I've been single most of the time I've been taking them and sex was one of my triggers so it could be due to that a little as well. Really hope you get some relief x