Urology

Long term antibiotic use is highly undesirable because as you have noted, the bacteria eventually become immune. Each time you take an antibiotic, the few bacteria that survive are the ones that have developed immunity and then reproduce, which are then the ones that become a new infection.

There may also be more than one kind of bacteria that are present, not just e.coli. While the most common, it's still only about 85% of cases. You can certainly have more than one.

Now there IS a difference between having enough bacteria colonizing to be classified as an infection by a test lab, and just having some bacteria. So if the cut-off for an infection is say 1000 bacteria, and you have 800 bacteria, the lab is going to say you don't have an infection from your sample, but it does NOT mean you don't have bacteria. And over time, those few that are left are going to be the ones that are immune to Macrobid.

There are a couple of things for you to think about. First, determining the cause of the recurrent infections. It's usually one of three things: hygiene, insertion, or physical abnormality (in that order). Keeping new bacteria out is the most important thing towards preventing another infection.

There are other things you can do too, especially with recurrent e.coli infections. You can try a cranberry product on a daily basis, such as TheraCran (if you don't like cranberry juice). While cranberry doesn't cure an existing infection, what the proanthocyanidins in cranberry do are bind to the p-fimbria of the e.coli bacteria so they can't adhere to and colonize the bladder wall. Note that the proanthocyanidins bind to your blood too, so it's important to consume your cranberry product twice a day since its activity diminishes over time. You need to take it about every 12 hours. This kind of measure is popular with people who have recurrent UTIs because it's not a drug and specifically deals with e.Coli if that's know to be the culprit. And it doesn't develop into a resistance either.

You should also probably be taking a good probiotic. Your body's own immune system is your best defense against acquiring another infection. Keeping yours healthy by restoring it with no less than a month of probiotics is a good idea, ESPECIALLY since you have been taking antibiotics so long. Make sure you take them at least 2 hours after an antibiotic dose or you're just chasing the good army with its death (antibiotic). The one probably best to take while you're still on an antibiotic is sacchromices boullardi (sp?), but after you stop your antibiotic, you can take any more comprehensive probiotic. It will help your digestive system too.

So back to hygiene, the number one cause of infections...hopefully your urologist has explained in detail all the things you need to do like always wipe from front to back, not the other direction. There's a British woman named Angela Kilmartin who has very practical advice on her web site and book about dealing with UTIs and cystitis. You may find her approach interesting.

Good luck.

thank you so very much for your advice. I will definitely start taking the probiotics as well. I am taking cranberry caplets already but so far only took one every 24 hours. My stomach gets very upset when I take too much and then I feel sick.
I also don't drink a lot - I hate water but will do this right now. Starting with this morning. You gave me courage and for that I am thankful.
As to hygiene, I use the bath tub like a bidet and wash thoroughly. I am paranoid about re-infecting. Plus I am single and have not had any bedroom activity for years since my separation. So it might be something physical or structural.
I need to clear this up because my orthop. surgeon will not perform the hip replacement surgery until I am declared free of infection.
Again, thank you for giving me courage.
Sabina.

Make sure the caplets you are taking do not contain any cellulose (many do). It might be listed as cellulose, guar gum, or something else. Cellulose binds to the active ingredient rendering the proanthocyanidins ineffective.

I understand that you may not be used to drinking a lot of water, but when your system flushes out regularly, it washes out the bacteria that would be hanging around. That 'rinse cycle' is another opportunity to get rid of bacteria, so drink a 2 liter bottle of water (or juice) every day. Better to avoid drinks with caffeine and sugar because both weaken your immune system.

Good luck.

wow, I checked my cranberry caplets and they do contain cellulose.....they are made by Inno-Vite 'UTI Protect'....the store told me they were the best......I am going there this afternoon and check if they have anything without cellulose.
Thank you for helping me, Counterso.

You will want a product that has at least 30mg proanthocyanidins per daily dose. There are around 35 cranberry supplements out in the stores. But if you're not interested in cranberry juice, your most natural source, start with one that has the science nailed, TheraCran. Your urologist should know about it.

Yuk, I have to take back what I found yesterday. It's pure Cranberry in caplet form but does not indicate any proanthocyanidins in it. I will try and change it and find also
another health food store.
Thank you so much. You have no idea how much I am clutching at this hope because the Macrobid is making me feel sick to my stomach and I just can't seem to function the way I am used to. I would take cranberry juice but it upsets my stomach and I am already on an antacid.
If I can't find the TheraCran here, I will find it online.
Thank you.

TheraCran will only be available online (or phone order). It's a restricted physician brand, so not found in stores (direct shipment only, like a mail order pharmacy, but you don't need a scrip) Proanthocyandins are in all cranberries (and other red/purple fruits). It's what makes them red. The question is how much of this important compound can be found in the product you're purchasing. If you don't know how much, then you can't calculate how much to take to get the necessary dosage for beneficial effect. Here's a short science video explaining (animating) how proanthocyandins work in your situation.
http://www.youtube.com/watch?v=u11DfF6fuCM

Yes, antibiotics frequently cause gastrointestinal distress. Some of that will be helped by reestablishing the good flora by taking a probiotic for several weeks.