UTI and antibiotics

[Bax21]

Hi My husband was diagnosed with MSA-P in October 2019. This is his first UTI. We went to our GP and the nurse prescribed MacroBID 100mg (Nitrofurantoin). He has been taking them twice a day just after meals. This is his third day and there seems to be very little improvement . He is still complaining of pain when passing urine. I have been dreading him getting a UTI as I am aware that UTIs will make his MSA worse - which indeed it has. But is it normal to be still in this much pain and shaking when urinating? Because it is his first UTI I am not sure but I don't know if he is actually allergic to this antibiotic. Has anyone else used MacroBID and had this reaction? If there is no improvement the nurse told us to ring 111 or the GP surgery but unfortunately it is a weekend and I doubt 111 will be able to advise me.. Any advise from the MSA community would be very much appreciated. Stella

[ReverendBadger]

If you have not seen it already do have a look at my post and the replies from about 3 months ago headed "NITROFURANTOIN (ANTIBIOTIC)"

My own personal experience of UTIs and antibiotics is that recovery is quicker if one drinks plenty of water at regular intervals, at least 2.5 litres a day, eat normally and rest. I would normally just stay in bed and read until the pain goes. I found that being active and moving about prolonged the pain. Drinking a lot means peeing a lot so does result in more episodes of agony but is necessary to flush the "bugs" out ! By the end of day 3 of taking antibiotics I would normally have noticed the pain reducing but not always, sometimes it would be more like day 4 or 5. All the above UTI experience garnered pre MSA diagnosis.

Post MSA DX I have only had one UTI but had a bad reaction to nitrofurantoin. It looks like some people don't tolerate it well , I would certainly agree it would be advisable to contact your GP as soon as practical.

[Bax21 in reply to ReverendBadger]

Thank you for your reply and we will both read your post on Nitrofurantoin. I think any future UTIs we will avoid Nitrofurantoin. I was just so disappointed as my husband rarely takes antibiotics so I had hoped they would kick in sooner and ease the discomfort - guess it's trial and error. Will go back to my GP.

[CanAmK in reply to Bax21]

So the nitrofurantoin is often he go to med for certain UTIs so sometimes you have to be an advocate. My husband does not seem to do well on it in terms of getting rid of the UTI but he doesn't seem to have reactions either. I just tell them up front he doesn't respond well. Sometimes they still want him to try it and sometimes they try something else. Good luck

[Bax21 in reply to CanAmK]

It's day 5 now on the Nitrofurantoin and my husband does seem to be turning a corner - albeit slowly. We will continue on it for the next two days and hopefully that will be suffice. We are still awaiting the results of the urine sample. Any future UTIs and I will request a different antibiotic that way we will know if he responds better. Thank you for taking the time to get back to me. Everyone has been so helpful.

[SaltyFlorist in reply to Bax21]

From my personal experience he should have seen significant improvement by now. He may have a resistant strain. If it were me I would seek emergency care. I’ve done it before. The infection had moved into my kidneys. I don’t want to alarm you but I do not believe this is a normal response.

[SaltyFlorist]

Is Phenazopyridine available where you are? It prevents urination pain whilst healing. It’s OTC in the US. I keep it on hand.

A severe UTI is among some the worst pain I have experienced. Crippling.

I use Bactrim as a prophylaxis and Macrobid for breakthrough infections. I have had good success with it.

I recommend you always have antibiotics on hand. If you have to wait for meds the infection becomes more severe, taking longer to heal.

Cranberry juice can also very helpful.

Pain medication .

Sincere wishes for quick relief.

[Bax21]

Thanks for your advice. I will look out for Phenazopyridine. I didn't know you could get antibiotics in advance - I assumed the GP had to have a urine sample before prescribing them. I will check with our Parkinson's nurse. And yes I agree cranberry juice will be better.

[diyducky]

Hello

If you contact 111 they should be able to put you in contact with an out of hours GP who can prescribe you an alternative antibiotic today rather than wait until Monday.

They do tend to ask a lot of questions that are not relevant and you have to be very clear with them about what you need and why.

L

[Bax21 in reply to diyducky]

I will ring 111 today to see if I can get an alternative antibiotic.

[Hightidelowtide]

Hello - I’m “not a doctor” but my husband has MSA and a lot of UTIs in the past. My understanding of UTIs and antibiotics is that it depends which bacterium is causing the infection. Some antibiotics won’t work if they are not the ones that “match” the bacterium that is actually causing the infection. Sometimes the first course of antibiotics won’t work. By day 3, if no signs of improvement, I would be contacting a medical professional to see if they would advise another course of treatment. (Did the gp/nurse send a urine sample to the lab - the results of that may be available and my show what bacterium is causing the infection). Male UTIs need vigilance because of increased risk of causing a kidney infection. Also, I would want to rule out urinary retention. 111 is a good place to start (I would say asap) - we have found them very helpful in the past, and they can arrange for an on call gp to phone you back given your husband’s MSA diagnosis/complicated health background. I hope you get the help and advice you need and I hope your husband starts to feel better soon.

[Bax21 in reply to Hightidelowtide]

I am going to ring 111 today and yes I handed in a urine sample to the GP . Thanks for your help.

[Polesden in reply to Bax21]

mmy GP gave me a phone a nnno that hoes straight to the 111 nurse ee and cut out lots of queries 0300 303 4365. Hope it helps

sorry about typos blame the BEAST!👾

sue

[Bax21]

Thanks Sue - I have made a note of the number for future reference! I already rang 111 and they put me through to a lovely Clinical Nurse who has asked for out of hours GP to ring me back - hopefuly within the hour. They were very caring and supportive.

[PaulaG3]

hello

Since sustaining a spinal cord injury I’ve had many UTIs. Nitrafurantoin is usually the first line antibiotic but sometimes this hasn’t been enough or the infection has recurred very quickly. I’ve then been prescribed Pivmecillinam. I tend to drink lots of water and take a F-Manoose supplement daily. I also have ‘dipsticks’ so o can see a change in ph levels due to lack of sensation. I hope your husband is much better now. X

[PaulaG3]

D -Manoose!