Dad\'s Continual Burning Issues

you're right Harley..there is a Black Box warning on Cipro
tinyurl.com/yaeyoy9
As for Bactrim..caution if there is a folate deficiency in the elderly which there usually is.
www.rxlist.com/bactrim-drug.htm
pat

Wasn't there a study published a while back about elderly people taking the fluoroquinolone drugs and resulting achilles tendon damage? I seem to remember this and also a recent study saying that the elderly should not take Bactrim for UTIs.

I wonder if when looking at lab results from folks with any type of urinary diversion, doctors remember that the specimen is coming from BOWEL and all sorts of bacteria is going to be there naturally?! When my Dad has his stents changed and the removed stents cultured, the report always says for Dad to "see an infectious disease specialist IMMEDIATELY!" based on the germs that show up (and there are some HEAVY-DUTY serious bacteria colonized on those stents.) However, there is a big difference between colonization and infection. As long as Dad has no symptoms, no treatment is required.

I'm just wondering if there are certain types of bacteria that don't always show up in bowel tissue and that's how they know which bacteria to treat?

S marcescens is naturally resistant to ampicillin, macrolides, and first-generation cephalosporins. In Taiwan, 92% of the strains are resistant to cefotaxime, but 99% are still susceptible to ceftazidime. Extended spectrum beta-lactamases are produced by most S marcescens strains.13

Serratia infections should be treated with an aminoglycoside plus an antipseudomonal beta-lactam, as the single use of a beta-lactam can select for resistant strains. Most strains are susceptible to amikacin, but reports indicate increasing resistance to gentamicin and tobramycin. Quinolones also are highly active against most strains.

Definitive therapy should be based on the results of susceptibility testing because multiresistant strains are common.


Antibiotics
Empiric antimicrobial therapy should cover all likely pathogens in the context of the clinical setting.
emedicine.medscape.com/article/228495-treatment
Explaining the generations of meds....see this article

www.emedexpert.com/compare/cephalosporins.shtml
And i take it all back i think as Cipro is a is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class. It is a second-generation fluoroquinolone antibacterial.
My brain was thinking Kefex......anyway its interesting material.....sorry if i confused you. my Bl2 shot must not have taken this week!
pat

Where in the article does it state that first generation cephlexen (cipro) doesn't touch it?? This is what it says about Cipro:
Ciprofloxacin (Cipro)
Greatest anti-P aeruginosa activity among the quinolones. May be particularly useful for isolates resistant to the aminoglycosides.

I have no clue what I am reading....it all sounds very clinical in terms which I don't know enough about. Please help me understand 1st generation vs 4th generation lingo!

Thank you.

aha..to continue the mystery
Ninety percent of patients with Serratia urinary tract infection have a history of recent surgery or instrumentation of the urinary tract..i.e. traumatic cath!
Now first generation cephlexen (cipro) doesn't touch it. Fourth generation does! Read this entire article and click on treatment regimens and give to your infectious disease doc.
emedicine.medscape.com/article/228495-overview
See if this doesn't make sense.
Pat

Hi Pat, Thanks for the article. It seems to be primarily for the "burning" during urination, which is not his case. I'm not sure what your definition of a traumatic cath is but I can recall in Jan (this year) when we had to rush him to ER for an IV drip (due to the intense burning) he improved then 2 days later the intense burning started up so the doc ordered a cath. According to my dad.....they used a LARGE tube that felt like it had perforated his urethra. Immediately following the cath...the burning stopped (what would that correlation be???). He got better again, was sent home with antibiotics, neurontin and pyridium and so the story continues.......

This last urine culture showed Serratia-Marcescens so he was given Cipro. That did absolutely nothing to the burning. He has been on Tylenol#3 every 8 hours for days/weeks now as it is the only thing that eases the discomfort. We saw a Pain Management doctor this week that is going to consult with an Infectious Disease doc to try and get to the underlying cause of the burning, which she believes is some very stubborn bug that is not being zapped completely. She gave me a very interesting article on the Clinical Implications of Gastrointestinal Biofilm. Perhaps we have a case of biofilm shielding these microbes??? I will try to scan and attach the article so you can read it.

He is also going to have an MRI done next week....the Pain Management doc ordered it so check out the spine, nerves, pelvic area, etc. Doesn't hurt to check those, right??

Well, I'll keep you posted on how we progress and if we make some headway. I am on a mission.....determined to find a solution!

Let me know your thoughts.......you always have such great feedback and advice.

Thanks,

Jackie