Culture and sensitivity for UTI

RN9742 · Jun 1, 2015

Maybe she meant that the patient was having an adverse reaction to the medication?!

jadelpn, LPN, EMT-B · Jun 1, 2015

I agree with the pp. The patient must have had stomach upset or some other issue with the Cipro, hence she is sensitive to it. And I bet the next time you see this patient, she will tell you she is allergic to Cipro......

As long as the Bactrim is also sensitive to the bacteria, then you are all set. Just look at the C&S and be sure.

JustBeachyNurse, LPN · Jun 1, 2015

Unless she misspoke and meant resistant. Sensitive to drug like described above (adverse effect like upset stomach can reduce compliance). Why not look at the report and see what it says? It also tells you the specific organism (most common are simple variants of e. Coli)

klone, MSN, RN · Jun 1, 2015

Unless she misspoke and meant resistant.

That's what I think - she misspoke.

Our C&S reports will usually list the various sensitivities to the most common abx as well.

Here.I.Stand, BSN, RN · Jun 1, 2015

Was the patient sensitive to cipro or was the organism sensitive to cipro? (You said "the patient was sensitive.") Big difference. My guess is that it either the nurse and misspoke and mean "resistant" or that the patient was having a side effect from the cipro.

Here.I.Stand, BSN, RN · Jun 1, 2015

As for reading the c&s report, they generally list common antibiotics and state "S" or "R" by each one

orange2015 · Jun 1, 2015

Thank you so much for comments. I will look at the C&S and find out whether the patient is sensitive to cipro or the bacteria is sensitive to cipro. :nurse:

Oceanpacific · Jun 5, 2015

The patient was started on a broad spectrum (big gun) antibiotic Cipro but the urine culture showed that the organism causing the infection could be treated with a smaller gun(Bactrim). It is common to use a broad spectrum antibiotic when the cause of the infection in not yet known because the culture is pending. The organism was sensitive to (could be killed by) both Cipro and Bactrim.

To avoid creating multi drug resistant organisms, it is important to save the big guns for only those infections requiring them. Hospitals have antimicrobial stewardship programs that look into how well the facility is at matching the appropriate antibiotics to the organisms which have been cultured.

klone, MSN, RN · Jun 5, 2015

The patient was started on a broad spectrum (big gun) antibiotic Cipro but the urine culture showed that the organism causing the infection could be treated with a smaller gun(Bactrim). It is common to use a broad spectrum antibiotic when the cause of the infection in not yet known because the culture is pending. The organism was sensitive to (could be killed by) both Cipro and Bactrim.
To avoid creating multi drug resistant organisms, it is important to save the big guns for only those infections requiring them. Hospitals have antimicrobial stewardship programs that look into how well the facility is at matching the appropriate antibiotics to the organisms which have been cultured.

Right, we get that. But according to the OP, the other nurse said:

patient was sensitive to cipro so they changed to bactrim

That's where the confusion comes in. Did the nurse mean that the patient showed a sensitivity, i.e. adverse side effect, to the Cipro, and that is why it was changed? Or did the nurse mean that the bacteria showed resistance to Cipro, and that's why it was changed?

Oceanpacific · Jun 5, 2015

Well we have no way of knowing what really happened with this patient. My intuition is that the change in antibiotic was made for the reason I described. However, you are absolutely right that the Cipro could have been discontinued if the patient had an adverse reaction to the drug.

amoLucia · Jun 5, 2015

If, in the future, DO NOT EVER give me any cipro. Don't know and don't care if I'm 'sensitive' or 'allergic'. Had the WORST GI nausea ever!