Recurrent UTI’s and Methotrexate

[Judywalks]

I have been having recurrent UTI’s for some time now and the urogynaecologist has prescribed a prophylactic antibiotic which has really helped. He wants me to go on a cycle of 2 antibiotics one of which is Nitrofuradantoin. My Rheumy has said that one is not good as it can cause Pulmonary Stenosis when taken with MTX. I am at present on 20 mg MTX and she has suggested what I think is a rapid taper off then stopping altogether. She said in a letter to gynae that she knows I won’t like this which is true because she has stopped Pred a few moths ago and I have complained to her that I am very achy and also anxious that I don’t have another flare of GCA. She has suggested to Gynae that if I don’t agree to stopping MTX quickly then his only other resort is to use a Penicillin based antibiotic. I was surprised at this as whenever I’ve had antibiotic s before I’ve been told to stop MTX for a week. I am confused and would like input from any of you lovely people.

[PMRpro Ambassador]

I confess I am somewhat confused as well!!!

You can stop MTX from one week to the next and you should do if you have an infection and even more importantly when you need abx. She seems a bit confused too - stopping MTX isn't like stopping pred which must be tapered and shouldn't be stopped in a GCA patient without VERY good reason.

Think you need an in-depth conversation with her!!!!!

[Judywalks in reply to PMRpro]

Any conversation is impossible with her. I have talked to GP about her non bedside manner but they say the only thing I can do is refer it to PALS.

[PMRpro Ambassador in reply to Judywalks]

You CAN ask them to mediate a switch to someone else on the grounds the relationship is broken. It is worth a try and cite what you have said to us.

[PuttyPenguin]

Hi Judy, I really sympathise with you. I have a problem with cystitis as well especially since I've had a flare-up and was put back to 60mg - now down to 30mg plus MTX. I imagine you take a lot of care of yourself however, just in case this helps... I take a sachet of a cystitis remedy every night plus d-mannose and this does seem to help a lot! Wishing you the best x

[Judywalks in reply to PuttyPenguin]

Thank you . I have tried D-Mannose but it didn’t seem to work for me.X

[Hunter134 in reply to Judywalks]

Not me either.I go on antibiotics but it keeps coming back.My urologist said it's the prednisone.Hope u get better and let me know what to do.Ive burned for a year and a half.ugh

[Paulagcl]

I had what I thought was recurrent cystitis and went through three antibiotics and then my primary care dr pushed the lab to redo the last culture and he came to the conclusion it was not an infection but an overactive bladder set in motion by the first infection. It seems there can be some discrepancy in interpreting the bacteria count. Anyway, I am on a drug for that, Myebetrig, and all my symptoms are gone for weeks now.

[Estellemac]

My Urologist suggested I take D-Mannose 1000mg twice a day and Cranberry tablet once a day. Ive just had Botox for a sensitve overactive leaky bladder and he couldnt do the first injection due to a UTI. I had to wait 6 months for the next appointment as they forgot about me and by that time had another UTI. Not the same as yours problem but the D-Mannose and cranberry seems to work not had a UTI since in 2 months. The create a barrier in the bladder that stops the e-coli forming on the wall. I was sceptical at first and suprised that a Consultant would recommend this.

[PMRpro Ambassador in reply to Estellemac]

The cranberry seems a tad superfluous - the active ingredient in cranberry juice is D-mannose!!!!

[Estellemac in reply to PMRpro]

I thought that a bit of overkill?

[Estellemac]

Sorry just read puttypenguins reply