What Happens Now?
Already one of the world’s most common types of infections, urinary tract infections (UTIs) are increasingly becoming resistant to main drug treatments. As the infections become resistant to antibiotics, what was once an easily cured malady is becoming an ailment for which standard treatments no longer work. Ampicillin, for example, was once a common, effective treatment, but it has now been largely abandoned because most urinary tract infections are now resistant to it.
The majority of UTIs are resistant to at least one or more antibiotics; however, the good news is that in general, the bacteria is not resistant to every drug. What makes it complex is that it’s not really a question of whether an infection is resistant to any drug, but is more a question of whether it’s resistant to the commonly-used drugs for that particular type of infection.
Effective Drugs that are Losing to Resistance
Resistance depends on “the bug and the drug” is what experts state – particular germs are resistant to particular medications. There is a small handful of front line medications that are currently recommended by organizations like the Infectious Disease Society of America. Two of these treatments are trimethoprim-sulfamethoxazole, known as Septra or Bactrim, and nitrofurantoin, which is sold as Macrobid. Both of these are available by prescription only.
But the resistance to Bactrim is growing.
Nitrofurantoin for the time being seems to be most effective; UTIs caused by E. coli are successfully treated by it 96% of the time, according to the New York City Health Department. Unfortunately, nitrofurantoin doesn’t usually succeed in cases of more advanced urinary tract infections where the illness has reached the kidneys. This condition is called pyelonephritis.
There is an older medication known as Fosfomycin that has been somewhat renewed as an alternate treatment, but it isn’t as effective as Bactrim or nitrofurantoin. There are also additional second-tier treatments on the market, however, they also have greater side effects and/or higher rates of resistance.
How to Know if Your Strain is Resistant to a Drug
The only way to know what resistance your particular infection has is to get a urine culture done. The lab results will show the specific germ and which medications would be effective for treatment. Sometimes, urinary tract infections can also clear up over a few days as the body fights the germs off. In other cases, however, symptoms can be caused by another ailment.
Most patients also don’t want to wait several days for lab results to come back so sometimes, doctors try to make a best-guess decision on which medication might work to treat the infection, given the patient’s symptoms and medical history of previous UTIs. Even if a patient is given an immediate prescription, experts recommend that a culture still be done. If the first medication doesn’t work, another can be given.
That being said, the Infection Disease Society of America discourages against doing cultures if symptoms of a UTI are not present. This is because some bacteria in the bladder is normal, and lab results can show a false positive. Symptoms may include burning, itching, a constant feeling of bladder pressure, and the frequent feeling of needing to urinate, even if the patient has just done so. More advanced infection symptoms can also include abdominal pain and a feeling of fullness.
The more frequently an antibiotic is prescribed to treat an infection, the more chances bacteria have of adapting to it and becoming resistant. It is for this reason that antibiotics remain “prescription only” medications. The over-prescribing and over-use of antibiotics only speeds up the resistance process, leaving complex maladies like urinary tract infections that are resistant to medications that at one time worked. For this reason, it is extremely important that you always seek medical counsel if you suspect you have an infection.
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