antibiotic misuse?

[adrienurse, LPN]

Just a qhestion that I've been meaning to find my own answer to, but haven't. On my LTC unit, there are a couple of people who have a history of recurring UTIs. For a long time they have been on prophylactic Septra DS OD in order to prevent re-occurance. Now somebody has suggested putting another UTI prone person on the same treatment.

Maybe I'm just uninformed, but this seems to go against everyting I've learned about antibiotic resistance. Sure you might be protecting the patient for a little while against bugs in the scope of Septra's sensitivity, but arent you just asking for resistant strains to start happening? And this treatment can't be good for very long. Nobody else seems to think that this is worth worrying about.

[jevans]

Hi

I work in the Uk and assume that septra is the same as septrin and yes we use it too!

I would prefer my UTI proned patients not to use these chemicals as I feel like you that they will become resistant.

I normally suggest that they drink plenty of cramberry juice. It has a mild antiseptic property to it.

best of luck

j

[Anagray, BSN]

I agree with Jevans. I'm also from another country, where antibiotics are used as last resort.

I had several UTIs as a child and only once antibiotics were used.

I don't know if there is an underlying medical issue in the patient u talked about, but imo prevention is the best way to handle recurrent UTIs - plenty of water, cleaning, etc.

We also use a weak solution of magnesium permanganate for rinsing ( i know this is not allowed here in US) especially if the patient is confined to bed, as well as calendula and camomile.

Since these methods are not approved here, good hygene and cranberry juice or pills are the best.

[slinkeecat]

I have to say that the problem with this world is that ABT (antibiotic therapy) is grossly overprescribed. I as a diabetic and with a hip replacement secondary to a MVA at 22 y of age was inudated with Antibiotics and my infection control doc told me that was one of the reasons a punture wound on my foot turned into osteomylitis and VRSA vancomycin resistant MRSA . I ended up having part of my foot amputated... yes diabetes was a complication, but I was a very controlled diabetic no circ disease.... and the bacteria was resistant to everything... we are creating hideous bacteria that won't go aaway becasue they are mutating and making antibiotics null and void.....This is just my opinion.... I think we need to focus on preventative measures for uti's which I am no stranger to. I take cranberry pills and drink lots of water and I have not had a uti in 3 yrs ... previously I was uti queen and constantly getting them.....just a thought....

Katy

[adrienurse, LPN]

Thanks for your suggestions. It sounds that this sort of treatment is not the norm. We're probably just talking about one MD's method of dealing with the problem of recurrent UTIs. Good hygiene and cranberry juice do go a long way.

[Sleepyeyes]

I had a relative who was constantly getting UTI's. She was on Bactrim qd prophylactically. She told me that once she felt the s/s of a UTI, if it wasn't tx'd in 48 hours, she'd be peeing blood and in agony.

I suggested she beef up her immune system with vitamin therapy. B complex, MVI, and Fe, Zn, and cranberry pills, and yogurt. She did it and within a few months, was able to drop the Bactrim without getting a UTI.

She also quit ETOH and cigarettes. I'm sure that helped boost her immune system as well.

Just some thoughts.