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Possible UTI and nitrofurantoin safety, troubleshooting

frozenborderline

Senior Member
Messages
4,405
I have bladder symptoms that could be related to prescribed ketamine usage at a higher dosage, or could be UTI. Since covid second wave is coming my pcp prescribed me antibiotics that are specific for UTI to try. Ot would be good if this was a UTI, and if the antibiotics help, bc ketamine is one of my only meds that helped me and if I have to stop it that would be bad.

So the main thing I want to know is of this specific antibiotic is linked to any problems in me/cfs. I don't want something like fluoroquinolones. That will ruin my health just from one course of use. But too tired to research it much. I'm fine taking courses the safer classes of antibiotics like beta lactam or tetracycline but I don't really know about this class. Tagging one person who knows about infectious disease treatments, but if anyone can think of others tag them in too.

This is also for a short course fur UTI so I don't care if it's a bit rough on the gut or something I'm purely interested in avoiding permanent damage like from floxxing.


@Hip
 

Rebeccare

Moose Enthusiast
Messages
9,064
Location
Massachusetts
@frozenborderline , I may be a little fuzzy but I don't see the name of the antibiotics you were prescribed in your post.

I don't know anything scientific about how certain antibiotics affect people with ME/CFS, but speaking from my own experience I've taken both bactrim and cipro for UTI's in the time that I've been sick and they didn't cause any problems.
 

Markus83

Senior Member
Messages
277
Are you male or female?

Did you have urine culture or at least a quick test ? What did it show (leukocytes, nitrite, erythrocytes)?

I wouldn't expect extrem damage like it is possible in fluorochinolones, but as far as I remember Nitro isn't a good antibiotic. I did some research years ago but I think it can cause severe lung problems or s.th. like that. For UTI there are several abx which can be used like Cotrim. But it depends on many different things. First of all you should know if there is an infection; and then culture with antibiogram would be good. This is often not possible in acute bladder infections of course because the results take 3 days or so.

If you get or have fever you must see a doctor, then Nitro is probably not indicated and you need a more systemic and stronger antibiotic.
 

frozenborderline

Senior Member
Messages
4,405
Are you male or female?
Male. Which I know is generally rare for utis but don't have great hygiene idk bc of being very sick
id you have urine culture or at least a quick test ? What did it show (leukocytes, nitrite, erythrocytes)?
no culture. It was Thanksgiving and the dr doesnt have quite openings and I didnt want to go to urgent care in the middle of second wave of pandemic in a major city
wouldn't expect extrem damage like it is possible in fluorochinolones, but as far as I remember Nitro isn't a good antibiotic. I did some research years ago but I think it can cause severe lung problems or s.th. like that. For UTI there are several abx which can be used like Cotrim. But it depends on many different things. First of all you should know if there is an infection; and then culture with antibiogram would be good. This is often not possible in acute bladder infections of course because the results take 3 days or so.
This is somewhat troubling. So you say it's not in same class of awful antibiotics as floxxie ones, no permanentdamage, but it issomewhat nasty? I just don't want to get permanently ill like people do with fluoroquinolones after even short courses. I already have severe neurological issues and connective tissue damage I don't need more. I don't mind in the moment having some bad feelings or side effects like the gut ones from say doxy or amoxicillin and then backing off it tho. I've even taken some kind of -azoles for cyst form of lyme and those were nastier than the amoxicillin and not great tolerated but they were still not causing permanent damage and once I stopped the side effects stopped.
 

frozenborderline

Senior Member
Messages
4,405
In this case it would be better if it was a UTI the. the ketamine. Bc one wouldn't mean losing one of my only helpful treatment options. But apparently utis are rare in non sexually active males. Idk.

I have presented w difficulty fully emptying, full feeling and urgency when not full, and ache and hurting and burning when peeing.
 

frozenborderline

Senior Member
Messages
4,405
It has gotten a bit better in terms of the emptying problem since stopping ketamine, which could he a coincidence, but the burning and ache didn't go away and it hurts when I press on the bladder a lot. I remember I used to get all these weird bladder symptoms as a kid which may have been frequent uti or tethered cord but I never went to the dr about it bc I was.embarassed and sometimes the pain was intense. But intermittent
 

lenora

Senior Member
Messages
4,913
Hello @frozenborderline.. Do you have other problems apart from the UTI's.

If you're on very high doses of ketamine, you may find yourself in rather severe trouble. I gather you're taking it for neuropathic pain, is that so? Most states (and again, I don't know where Vermont stands in this) are in the midst of clamping down on not just opioids but almost any drug that helps relieve severe pain. I hope this isn't happening in your area. It did down here (TX) about 2 yrs ago and, trust me, it was most difficult. We were just abandoned, and the final upshot was that we had to be seen by a psychiatrist (not too many visits, sometimes just once) and, in the end, our neurologists or other specialists couldn't treat us and we had to go to specific Pain Specialists. Not easy, I can assure you, and I gather you're on Medicaid, so that would make it even harder. Try to find anything you can on your computer....stay ahead of the game.

Do you require care? I'm sure you qualify for Meals on Wheels, are you in that program? I am concerned about your groceries, though....how are they being provided? Lots of questions from us.....and i hope you'll soon get the UTI under control. They are miserable. Yours Lenora.
 
Last edited by a moderator:

Markus83

Senior Member
Messages
277
In Germany you can buy test stripes like these in the pharmacy: https://www.roche.de/diagnostics/te...are-diagnostik/combur-5-test-hc.html#Merkmale

If it is possible I would send a family member to buy this for you and then test yourself. This would answer at least if you have an infection. I don't know how acute your symptoms are, so this is based on the assumption that you don't have an acute UTI with e.g. fever, .... UTI can grow out to an infection of the kidneys and even sepsis. So it can be a real dangerous thing. UTI in male are per definition "complicated", so Nitro is not indicated in my eyes (I'm not a doctor but have experience with years of chronic bacterial prostatitis). Isolated bladder infection is barely possible in men because of the anatomy. That means the prostate is practically always involved.

Concerning the urine culture you can draw the urine sample by yourself at home and send someone else to bring it to the doctor or even the medical lab. At least in Germany it would work that way. The urine has to be relatively fresh, I would say not older than 1 hr.
 

Mary

Moderator Resource
Messages
17,334
Location
Southern California
I don't know anything scientific about how certain antibiotics affect people with ME/CFS, but speaking from my own experience I've taken both bactrim and cipro for UTI's in the time that I've been sick and they didn't cause any problems.
Cipro is a fluoroquinolone -it has a black box warning about possible tendon damage. One of my sisters had tendon problems for several years and even had to have surgery after taking a fluoroquinolone. They also can cause a host of other very severe problems - it's called getting "floxed" - When antibiotics turn toxic (nature.com) Like other black box warning drugs, doctors are told they should only be used as a last resort, when nothing else can help, but most seem to ignore this. I've had 2 doctors recommend fluoroquinolones to me for different things - I refused each time and so they gave me an old safer ABX.

Another UTI drug is keflex, I've taken that with no problems. Though when my mother was in her upper 80's, keflex caused her to be a little psychotic - she began to think people were poisoning her. And buried in the very fine print of all the effects was mention of this possibility. Her psychosis disappeared when the keflex was stopped.

I'm prone to UTIs (I think one of my kidneys has some damage from a severe infection years ago). Anyways, taking a cranberry supplement daily has helped prevent them. I have read good things about d-mannose too, though it's a bit pricey to take regularly.
 

frozenborderline

Senior Member
Messages
4,405
Normally I'm skeptical about supplements , but the d mannose has pretty great reviews in terms of efficacy from sites that are normally if anything a bit hard on herbs and non pharmaceutical supplements. So it looks promising.
 

frozenborderline

Senior Member
Messages
4,405
If it is possible I would send a family member to buy this for you and then test yourself.
I don't think we have these in pharmacies over here.
would answer at least if you have an infection. I don't know how acute your symptoms are, so this is based on the assumption that you don't have an acute UTI with e.g. fever, .... UTI can grow out to an infection of the kidneys and even sepsis.
hmm I guess I don't know much about utis. When I have had what I thought were utis in the past they seemed self limiting and never gave me systemic symptoms like fever , or kidney pains. It was always just burning, flow issues and overwhelming feeling of urgency all in my bladder. Is there anything that mimics UTI symptoms without the systemic stuff ? Like some kind of bladder inflammation?
I've had 2 doctors recommend fluoroquinolones to me for different things - I refused each time and so they gave me an old safer ABX.
I'm always so worried I'll slip up and forget that fluoroquinolones are bad since they seem to cause permanent damage with even short courses. It terrifies me bc im too often in charge of my own medical care, without enough help.managing it , and I feel like with brain fog I might slip up and forget. But it does seem like doctors are phasing them out more and more these days. All cfs docs are aware buti worry more a pcp or er doc may give me one.
 

kangaSue

Senior Member
Messages
1,851
Location
Brisbane, Australia
Is there anything that mimics UTI symptoms without the systemic stuff ? Like some kind of bladder inflammation?
Problems with the prostate can do it. Interstitial Cystitis is another thing and ketamine used recreationally can cause similar issues to this so Urologists are using the same diagnostic criteria for interstitial cystitis if ketamine is suspected to be causing some bladder damage. If your issue involves having some discomfort in the left testicle too, renal Nutcracker Syndrome is a other possibility.

UTI's can be self limiting but I think they tend to escalate more rapidly in men than in women in cases of bacterial infection. Trimethoprim is the first line of antibiotics I'm usually prescribed for frequent UTI's. I used to be able to keep them at bay with just vitamin C (1000mg 3 x a day at the first signs of a tingle when peeing) as a urinary acidifier but don't tolerate it at that level anymore. I can often keep them at bay now taking Hiprex (methenamine) instead, but it's also pretty hard on my gut.

Here's some good info on treating UTI's;
https://www.chronicutiaustralia.org.au/treatment/

https://www.sahealth.sa.gov.au/wps/wcm/connect/c7a3f980432af25ca680f68cd21c605e/Clinical_Guideline_Empirical_Treatment+of+Bacterial_UTI_v1.0_06.06.2019.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-c7a3f980432af25ca680f68cd21c605e-n5irFTp
 

Hip

Senior Member
Messages
17,824
Is that a commonly used medical treatment ?

D-mannose can work well if the UTI is from Escherichia coli bacteria (the most common cause). This sugar prevents the bacteria sticking to the bladder wall, so then they just slip off and are flushed out in the urine. Does not work for all species of bacteria though.
 

frozenborderline

Senior Member
Messages
4,405
Here's. a scenario I'm desperate to have answered. Could UTI be worsened by Inflammation caused by ketamine. I'm just really really hoping this isn't from ketamine bc my doses were moderate and still giving me symptoms and its literally the only med that had hel3pd me recently. But wondering if there are drugs to help the side effects or ketamine inrlmamation and furthermore if a UTI coulr make one more sensitive to them, but then one would be able to use ketamine after UTI gone.