Talk to Gynecologist on Repeated UTI
Asking for Mother, Female, 53 years old, Lahore
We’ve been dealing with repeated UTI that now every oral medicine is resistant and as well as iv too (meropenem) my mother has pus and cloudy urine with foul smell but bit better than before but it’s still there and she’s been dealing with klebsiella pneumonea (bacteria found in her urine culture she just done with her duracef 500 2 thrice a day for 7days now the pus is still there with foul smell kindly help me out with this we can’t afford to hospitalize her but need some good assistance
I am so sorry to hear about your mother’s ongoing struggle with these infections. Dealing with highly resistant bacteria like Klebsiella pneumoniae (especially when resistant to strong antibiotics like Meropenem) is extremely serious and requires specialized medical management.
Because this involves multi-drug resistant (MDR) bacteria, you must consult an Infectious Disease (ID) Specialist or a Urologist immediately. This is not a condition that can be managed with home remedies or standard over-the-counter advice.
Immediate Recommendations
Do Not Self-Medicate: Using the wrong antibiotic or an incorrect dose can make the bacteria even more resistant and harder to treat in the future.
Repeat Urine Culture & Sensitivity: Since she just finished Duracef and symptoms persist, a new culture is needed to see if the bacteria has changed or if a new strain has emerged.
Check for Underlying Causes: Repeated UTIs, especially with resistant strains, are often caused by something else. A doctor should check for:
Kidney or bladder stones.
Diabetes (high blood sugar fuels bacterial growth).
Structural issues in the urinary tract.
Incomplete bladder emptying.
Hydration: Ensure she is drinking plenty of water to help flush the urinary tract, unless a doctor has restricted her fluid intake for other reasons (like heart or kidney failure).
Understanding the Risks
If the infection is not fully cleared, there is a high risk of Urosepsis (the infection entering the bloodstream) or Pyelonephritis (kidney infection). If she develops a high fever, chills, back/flank pain, or confusion, she needs emergency medical attention regardless of cost, as these are life-threatening signs.
resistance case
consult urologist
control sugar if diabetic
go to a government hospital it is not a case to be treated and taken lightly she might need hospitalisation and there is a chance of ascending urinary tract infection
Better to visit urologist for this
Prof. Homeopathic Dr. Syed Atta E Rasool Bokhari - Homeopath
DHMS, RHMP | Lahore
100 Positive Reviews
YOU CAN DO EXPERIMENTS BUT
SINCERE ADVICE.
YOU WAS DOING SUPPRESSION IN PAST
THAT'S WHY PATIENT IS SUFFERING NOW.
YOU SHOULD DIAGNOSE THE TRIGGERING FACTOR AND ROOT CAUSE.
TREAT THAT FOR PERMANENT RECOVERY.
I HAVE A PATIENT FROM ARMY BACKGROUND WHO ALSO HAD SAME UTI PROBLEM AND HE ALSO HAD RECURRENT STROKE TOO.
I CAN DEAL WITH YOUR MOTHER UTI WITHIN ONE MONTH HER UTI WILL BE CURED.
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Patient
Post Owner
I’m not self medicating anything her treatment is undergoing in medical specialist in CMH but the main thing is that she Allhamdullillah doesn’t have any diabetes or hypertension but yes she has dementia history of right side TIA and now after undergoing multiple treatments of antibiotics acute kidney injury but she drinks penalty of water as doctor has prescribed her to take care of her bladder and kidney rest she has been thru urosepsis before and the treatment didn’t help much last time now Allhamdullillah she’s stable and not showing any signs of fever chills or vomiting but still she does have some foul smell in her urine and now all I want to know what are the possibilities of drug combinations that can help us to get rid of it as staying in a hospital is quite difficult for me to manage cuz I’m all alone managing everything and I can manage the iv treatment at home if recommended by the doctor and can manage test results as well.
1 week ago
MBBS | Rahim Yar Khan | Book Appointment
Thank you for providing that additional context. It is a relief to hear she is under the care of specialists at CMH and that she currently does not have a fever or vomiting. However, the combination of multi-drug resistant (MDR) Klebsiella, a history of urosepsis, and a recent acute kidney injury (AKI) makes this a very delicate clinical situation.
When dealing with carbapenem-resistant Enterobacteriaceae (CRE) like this Klebsiella pneumoniae, doctors often look at "synergistic" combinations.
Potential Drug Combinations for MDR Klebsiella
Because she has had a kidney injury, the medical team must be extremely careful. Some effective drugs for this bacteria are "nephrotoxic" (harmful to kidneys). Common strategies include:
Newer Beta-lactam/Beta-lactamase Inhibitors: Drugs like Ceftazidime-avibactam (Avycaz) are often the first choice for Meropenem-resistant Klebsiella because they are generally safer for the kidneys than older alternatives.
Combination Therapy: Specialists may combine a "backbone" drug with others to increase effectiveness, such as:
Fosfomycin: Often used in combination with other IV drugs because it can reach high concentrations in the urine.
Tigecycline: Sometimes used, though it is less effective specifically for UTIs as it doesn't concentrate well in urine; it’s usually paired with another agent.
Colistin or Polymyxin B: These are powerful "last-resort" drugs, but they carry a very high risk of further kidney damage, so they are used with extreme caution in patients with a history of AKI.
Aminoglycosides: (e.g., Amikacin) Can be effective but also require strict monitoring of kidney function.
Managing IV Treatment at Home
Since you are managing her care alone, you can discuss Outpatient Parenteral Antimicrobial Therapy (OPAT) with her CMH doctors. This allows a patient to receive IV antibiotics at home.
Requirements: A stable IV access (like a PICC line or midline) and a home nursing service or your training to administer the doses.
Monitoring: Because of her history of AKI, she will still need frequent blood tests (Creatinine/BUN) to ensure the antibiotics aren't damaging her kidneys again.
Important Note on Dementia & TIA
Patients with dementia and a history of TIA (mini-stroke) can sometimes have "silent" infections. In the elderly, a foul smell or cloudy urine without a fever can still be significant, as their bodies may not mount a traditional fever response.
Next Step: Have you received the most recent Culture and Sensitivity (C&S) report? If you can share the names of the antibiotics listed as "S" (Sensitive) or "I" (Intermediate), I can help you understand what those specific options mean for her kidneys.
1 week ago