What is the protocol to treat a patient sensitive to or allergic to the appropriate antibiotic?
Question posted by KikiHart on 7 Dec 2013
Last updated on 28 January 2018
I have a UTI. It was cultured as sensitive to sulfa, which I am allergic to (I am also allergic to penicillin, but so far I have been able to tolerate penicillin derivatives like Keflex and Suprax). The infection is also sensitive to Ciprofloxacin and Levofloxacin. The last time I took Cipro it made me nauseated, very dizzy and it felt like my joints were on fire. I also have since developed bilateral tendonitis in my Achilles tendons. I don't know if it is related. I have been told by my PCP that if I am unwilling to take the Cipro or Levaquin then I cannot be treated. Is there seriously no other solution?
I am new to this PCP (the result of changes in insurance). I do not have history positive or negative with this PCP. I do have a history of recurring UTI's. The UTI's have become a huge problem because of the antibiotic issue.
I have been given to understand that if a patient is sensitive to multiple antibiotics then they are simply out of luck - is this true? I would almost rather try the sulfa and manage the reaction then try the Cipro, but once you tell a physician you are allergic to an antibiotic you are out of luck.
I understand my mom is allergic to like everything. They can't tell u that u r out of luck. There is antibiotics u just have to try more until u find right one.
Votes: +0
LI
Livda
28 Jan 2018
I sympathize with your Mum. As we age, and if unlucky enough to have had quite a few illnesses and treatments, they seem to "mount up" and by the time we are Seniors the whole medical system is, to me, more an enemy than a help. I am now 74; when treated for cancer of cervix stage 2, in my forties, I had been told it was " nothing " by several GPs ... then unfortunately, had a "reaction" - or whatever you want to call it, to one of the drugs while receiving radiation - nothing to do with the cancer, but I asked for something mild for my nerves - expecting something just to take the edge off, but either a mistake was made or? I had a very bad reaction which led to my being hospitalized for the rest of my radiation. After those years, I developed what may be IBS-D - and it is a life changer. Thankfully I am retired and the bathroom is not far away. But I cannot travel etc. Then had laser treatment to eyes; goiter on neck which Dr.
said he couldn't feel: then had right side of thyroid and goiter removed and on Synthroid for life. OK, I DO realize things could be much worse... but with life's other problems (eg abusive marriage; family in another country; nephew dying Christmas Day, etc. etc, etc.) it sort of thins out your ability to respond to everything! Had I known that a Quinolone drug like Norflox would leave me with peripheral neuropathy, pain, numbness, etc. etc. etc. I would never have taken it: but some here feel that this is the price we have to pay for a bladder infection? The radiation to pelvis fried my bladder, injured my bowel and other pelvic areas... yes, I am alive whereas I have lost my brother, Dad, grandmother and other relatives to cancer and my husband now has it. Yes, everything is relative - so we should not tell others whether or not they should or should not take a prescription drug regardless of the consequences, IMO. Personally, I have had it and going to Heaven some days feels pretty good to me. But you all sound as if you are younger with your lives ahead of you? All I can say, is that I feel women in general, Seniors in particular, and bladder infections generally are not regarded as very important, but they are - because like any infection, can lead to death. I read that half the women over 60 have these bladder infections, and in Old Age Homes, they are given frequent strong antibiotics which lead to other mental and physical impairment - and no one realizes it could be the drug! I am waiting, in Canada, to try Marijuana ... and if that doesn't help, will be saying Adios amigos.
RO
Roz36
17 Jan 2018
Fosfomycin is a one shot powder that works within hours. If you have recurring UTIs you should try an infectious disease doctor. They are more proactive when it comes to treatment. Good luck
Votes: +0
LI
Livda
17 Jan 2018
Thank you. I will check out the Fosfomycin... and yes I would feel better seeing a specialist - even the urologists here look, see, and don't recommend any action. I have radiation damage from pelvic radiation 1985 - glad to still be alive but radiation takes its toll even many many years later. I have done some home research on Quinolone drugs and they appear to be a last resort solution and it was not apprpriate to have it prescribed that time... the G.P.s are just so busy these days and lets face it, as women, and as older women, there just isn't the interest - or that is how I feel. I would even find the money to pay to visit someone who can even spend two hours with me - and go over everything and come up with a plan! It's worth saving for!
RO
Roz36
17 Jan 2018
I had 10 UTIs in 2016 that caused me to have a bout with cdiff from all the antibiotics I had to take. The urologist I was seeing who never looked for a cause but kept on prescribing more antibiotics sent me to an infectious disease doctor who only prescribes the fosfomycin. He also felt that my kidney stones were contributing to the problem and so last February I had the kidney stones zapped. I was fine for several months but then started to get the occasional infection so I am now on a weekly dose of the fosfomycin as a preventative. Three months infection free. Again, good luck.
LI
Livda
28 Nov 2017
I now have peripheral neuropathy because my Dr. prescribed Norflox for a mild UTI. Please read the side effects for Quinolone Drugs. There is no other drug I can take as also Amoxillin is out. So.. if we cannot take the required drugs, do we die?
Votes: +2
AN
Angelbmw123
23 Aug 2017
I have the same problem Gentamicin 160mg daily IM injection for 6-10 days does it for me.
Votes: +1
AB
abartons
25 Sep 2014
Hey KikiHart, No, your not out of luck! I'm allergic to the 3 medications that are used to treat UTI's (macrobid, cipro, and sulfa). My PCP prescribed me Monurol (Fosfomycin Tromethamine).
Also, have you used Macrobid to treat UTI? Ask your PCP if they can prescribe that instead of Cirpo. Actually, the symptoms that you experienced with Cipro were a horrible side effect, especially the joint/Achilles pain. It's not an allergy, but it doesn't mean you have to suffer.
Now, about your allergic reaction to sulfa medication, if it's not a life-threatening allergy(ex. your throat swells shuts); then you can take the antibotic with either benadryl or hydroxyzine, that should minimize the reaction. I've done with some medicines, that contain an inactive ingredient that I have a mild allergy to. If your not comfortable with that option, it's ok.
Just remember there are other options to Cirpo/Levaquin. I think that it's horrible that your PCP put you in a corner, without doing some simple research on alternative UTI antibiotics.There are other antibiotics besides the big 3 that treat UTI's.
I hope that this info was helpful, Feel Better & Never Give Up Hope :D
Votes: +1
KD
KDelphi
3 Oct 2014
Good Gawd, don't tell someone to take an antibiotic they may be allergic to with benadryl, without having them see a doctor first! Are you bonkers? signed, an MSW
I cannot take penicillan (anaphylactic reaction), and Cipro makes me very ill. Yes, Macrobid might be an option... if we had natl health insurance in this country, no on e would be going to this guys/girls' PCP... gheez
I am takin g Cipro for an abscess tooth right now, but no more. If they cannot find something else that will work for it, I am just going to have it pulled and blame it on the US for profit health care system
AB
abartons
3 Oct 2014
Of course, I meant with a doctors consent! Gezz, you know the rule, always discuss medicine options with your doctor first before doing anything. It was meant as a possible idea you can discuss with your PCP. I'm sorry, I should have said that in parenthesis. Technically, hydroxyzine is a prescription antihistamine, not an OTC(Over the Counter).
CA
carolalute
26 Aug 2016
I've had utility infections for years. I finally realized I was taking too many antibiotics and had to stop. I researched natural remedies and found 2 different articles that suggested Alka seller original. The b Next time I felt a uti coming on I tried it and it worked. I've used ever since. 1 packet every 4 hours for a few days and it's gone. You may want to try it.
FA
fairways
18 Jan 2017
I have had 15 uti's in 16 months. I am allergic to penicillin, cipro and sulfa drugs. I took Keflex and doxycycline. I took Macrobid prophylactically for 8 months. I now have peripheral neuropathy in both feet. I believe all these antibiotics have poisoned my system. Is there any drug that I can take besides an antibiotic for a future UTI?
Go to the Mayo Clinic in Rochester, MN or an advanced facility like it closer to home. Do not try to solve this on your own.
Votes: +0
KA
kaismama
7 Dec 2013
Who told you that? What other ones was it sensitive too? Keflex and suprax aren't penicillin derivatives. Keflex and suprax are cephalosporins, however a small percentage of people allergic to penicillin can't take cephalosporins. If the only other antibiotic its sensitive too is cipro, then there is nothing to give you, but if there are degrees of sensitivity, there will be some that are moderately sensitive and taking 2 of those often work.
Votes: +1
KI
KikiHart
7 Dec 2013
I talked to the NP yesterday. From what I understood the 3 antibiotics were my only choices, I pushed because in the past I have been able to treat with Suprax. It trashes my stomach but it is strong enough that if I can stay on it for 3 to 4 days it will knock out the infection. So, I asked specifically about Suprax and she said no, it was not on the list.
KI
KikiHart
7 Dec 2013
If I understand you correctly, if I can't take the antibiotic then I simply can't be treated. There is no standard protocol for treating patients with allergies more than one antibiotic.
IN
Inactive
8 Dec 2013
If you are allergic to the antibiotics that this bacteria can be killed with - then yes, you cannot be treated. Simple as that. If the antibiotic that works and kills this bug kills you because you are allergic to it, then your doctor has no choice - they cannot prescribe a medication for you knowing it will kill you. What kaismama was saying is that there are degrees of allergies - no, you wouldn't ordinarily take something you are allergic to. But, in this case, you and your doctor need to figure out if one of the antibiotics that kill this bug, can you tolerate just long enough to kill this bug? Sometimes we have a Sensitivity vs an allergic response to a med. An all out allergy means that we stop breathing if we take it. A Sensitivity means that we have really bad side effects, or some trouble breathing, but we could use it, along with an inhaler and some antihistamines - if you absolutely have to take it. Looks like you are at those crossroads right now.
But your doctor may not be willing to take that risk. You could drop over dead and then they would be responsible for giving you something you were allergic to. What did your doctor say? Were they willing to try one of the antibiotics that worked on this bug? Are you willing to take a med that you are allergic, or sensitive to, and take that chance? I know where you are - I am in the same position with antibiotics. It gets to be very tough figuring out which thing will kill me - the germ, or the medication to kill it, which can kill me. Hope you find a way to get better! EJ23
IN
Inactive
8 Dec 2013
Does this bacteria respond to Macrobid? That was the antibiotic I used for the first 20 or so UTIs I had. EJ23
KI
KikiHart
8 Dec 2013
I am not getting much conversation on the subject. I was told the bacterial count was high, indicating the infection needed to be treated. Cipro and levaqui were my only options.
With a previous PCN I suggested we try the sulfa. It was some 15 years ago that I had sulfa. I did get hives but a relatively mild case compared to penicillin. He wouldn't go for it. Hives are preferable to what I went through with the Cipro.
IN
Inactive
8 Dec 2013
I did penicillin testing at my allergist last year - found I was no longer allergic to it. I asked about testing for sulfa but the allergist said they don't do that, once you are allergic to sulfa you are always allergic.
I don't know what to tell you. I'm in the same boat but fortunately haven't gotten to where I had an infection with nothing to treat it. It's Not Good!!! Let me know what you end up doing, ok ? EJ23
KI
KikiHart
8 Dec 2013
My question is what is the protocol? I am not getting any conversation from this NP. What happens with other people when they are allergic to antibiotics.? Are they simply turned away and left to die, untreated. That sounds a little barbaric.
IN
Inactive
8 Dec 2013
What protocol? There is none. What would you have them do? Kill you right away with something you are allergic to? It's not anything against you - they aren't doing it to be mean or cruel - You have an allergy. I don't know what you expect them to do - ethically they can't prescribe a medication that you are allergic to. What options, if any, did the nurse practitioner give you?
IN
Inactive
8 Dec 2013
You could take the Cipro. You may have a lot of problems with it but at least you won't die, as leaving a bladder infection left untreated will eventually do. Leaving an untreated infection just weakens the body's immune system, and the infection will spread to the kidneys, and eventually will kill you. I don't know if you are aware , but the bladder has the most nerves of any organ in the body . An untreated bladder infection will lead to some serious pain!
Perhaps use the Cipro to get rid of this infection, then investigate alternative ways to keep the bladder from not getting infected. Just my advice - EJ23
IN
Inactive
8 Dec 2013
What about the Levaquin?
KI
KikiHart
8 Dec 2013
So, there is no standard protocol and patients who have allergies are then simply shunned by the medical community? Again, that sounds barbaric.
From what I am given to understand UTI's are not necessarily that serious. What I expect is a dialogue. I expect to be given options. This is why I asked about the standard protocol. If my NP wasn't going to offer any I wanted to be able to walk into the visit with valid medical options.
But from what I hear if you have an allergy to antibiotics you die.
The part that I find extremely frustrating is I have read allergies to penicillin can go away. It is possible that I now will tolerate penicillin without a problem. The same could be true for the sulfa. My initial reaction was mild. I would be more than willing to risk a case of hives over what I went through with the Cipro.
IN
Inactive
9 Dec 2013
Maybe you can find a doctor who will prescribe it for you. What about the Levaquin-sp? Have you tried that before?
KI
KikiHart
9 Dec 2013
As I understand it levaquin carries the same risks as Cipro.
I have no idea of how to find a doctor who could address this problem. None.
I had scheduled an appointment with the NP for tomorrow, but I am thinking now I will just cancel. I was hoping I could suggest some appropriate path but obviously that is not an option.
IN
Inactive
9 Dec 2013
From their point of view you have two alternatives - Cipro and Levaquin - you are not allergic to either. You may have serious side effects from Cipro, but it will kill this bacteria. And you haven't addressed why you don't want to try the Levaquin. They certainly aren't leaving you to a certain death by not treating your infection. You are doing that.
I suggest you try your question again and I won't reply to it. Maybe someone else can help you better. I am getting nowhere - except being exasperated. I wish you well. - EJ23
IN
Inactive
9 Dec 2013
Have you been evaluated by a Urologist? Perhaps they could help. I know mine helped to teach me how to take away a whole lot of my propensity to get URIs continuously. Prophylaxis, eating different foods, cleaning - lots of little tips that keep my bladder healthy. Maybe they would know if a short dose of Cipro would kill this bacteria)
KA
kaismama
11 Dec 2013
There isn't a protocol. What happens to you with these allergies? Many times I've found that people say they are allergic to a med if they get diarrhea or some other stomach problem, which has nothing to do with an allergic reaction. A true allergic reaction is hives, difficulty breathing, and anaphylactic shock. The problem when docs don't differentiate between sensitivity and allergy is what you're having now.
KA
kaismama
11 Dec 2013
Ej when I said sensitive too, I was referring to the bacteria. But the sensitivity you speak of is important too.
KA
kaismama
11 Dec 2013
Oh, and I have never met a patient allergic to all antibiotics. It seems an impossibility since there are so many different classes of antibiotic.
KI
KikiHart
12 Dec 2013
I do understand the difference between an allergy and an upset stomach because antibiotics are tough on the stomach. I also understand that there are many different types of antibiotics. There are several that I can take. I am being told that this infection is not sensitive to those antibiotics. I am being told those antibiotics are not an option. That is why they do a "sensitivity" with most cultures.
My hope was that someone knew about what was expected, what was the standard of care for a patient who had multiple allergies. And from what you are saying, there is none. So in effect those patients do not get treated.
The lesson here is not to become allergic to antibiotics.
AL
allison2099
2 April 2015
I'm extremely allergic to Penicillin,Sulfate & Fluroquinlone (Ciprofloxacin, Levaquin). I've had several bladder infections recently. I've been treated wit Ceftin( Suprax) doesn't seem to be prescribed any longer) & Flagyl. There are some other medications, macrodantin(?) & possibly Clindamycin. I would never let My patients take any fluroquinlone. So many people (including me) have had serious to deadly reactions that there is a class action lawsuit underway. They should be banned or only used as a last resort. NEVER take something you're allergic to unless you undergo a desensification program in a hospital. I went through this myself with a specialist from Johns Hopkins Hospital to enable be to take one course of penicillin to save my life. This is a rare thing & needs strict observation to be done (in intensive care no less). It didn't cure My allergy but I'm still alive. I had terrible thrush & yeast all over but I survived... I hope you found a new Doctor. Alli
