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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 20774
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I get frequent urinary tract infections and tonight I have

Customer Question

I get frequent urinary tract infections and tonight I have been up and down to the loo every hour or so with frequency and burning in spite of taking Trimethoprim 100mg twice a day for two days so far. Usually Co-Amoxiclav antibiotics work fast for me, but because I had a tummy bug with diarrhoea, I thought it best to try Trimethoprim instead.
A specialist has recommended that I take three different antibiotics at reluctant to do this but did try a couple of doses, and I vomited at the last attempt.
I cannot go on like this, as the infections are painful and interfere with my daily living.
Can you advice any treatment?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Hello from JustAnswer.
Have you been tried on anything to prevent the infection once the acute infection is controlled?
Are you taking any chronic medicines for any other medical problems?
Customer: replied 3 years ago.
I take medication for asthma and Omeprazole for reflux regularly. I was tried on a low maintenance dose of Trimethoprim but it made me feel unwell.
Customer: replied 3 years ago.
I have primary immune deficiency for which I have replacement immunoglobulin every four weeks. The Consultant advised that should take three different antibiotics, C-Amoxyclav, Trimethoprim and Nitrofurantoin together twice a day for six months, but I was nervous about taking such a regimen, and vomited on one occasion when I took a dose of these three antibiotics.Is this the only alternative now for me to knock these bactaria on the head?
Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There are two aspects of care to consider in this situation - treating the acute infection and trying to prevent the recurrent infections.

For treatment of the current acute infection, I would usually prefer to use a single stronger antibiotic, rather than three different antibiotics. There are several stronger antibiotics that can be considered and the results of a culture will usually guide the selection. If a culture is not available, I would usually consider the use of Cipro or Levaquin.

As for prevention, the usual first intervention is a low dose of antibiotics. Since this has already been tried, another option would be the use of a supplement, D-mannose. D-mannose has been touted to be used both for treatment of UTIs and prevention of UTIs, but the clinical studies show that it works better at preventing UTIs, while not very effective at treating the acute infection. It appears to work by affecting how the germs attach to the lining of the urinary tract. There are no specific studies in people with immune deficiencies, but this still may be able to help as it is not dependent upon the immune system.

If I can provide any clarification, please let me know.