Recurring question about UTI with Serratia & treatment with Gentamycin.
November 6, 2010 | 10,00 EUR | answered by Dr. med. Olaf Stephan
Thank you for your response.
What does "hematogenous spread through the blood" mean?
Are further tests necessary, or is it usually sufficient to be treated with 160 mg/day for 5 days?
How can I be sure that there are no bacteria left afterwards that are also resistant to gentamicin?
That is my concern: Shouldn't this last effective medication be "saved" for serious complications?
What is the risk of hearing damage with this medication and is it true that one should take 1g of aspirin daily with it?
The second germ is sensitive to nitrofurantoin - can it be combined without hesitation?
Is the germ contagious, or do I need to observe any hygiene measures at home?
Am I understanding correctly: This germ is also present in a healthy person - it just doesn't belong in the bladder?
Dear inquirer,
In this case, hematogenous means that the bacteria from the intestine, for example, have entered the urinary tract area through the bloodstream. For safety and to plan any further therapy if necessary, the urine should be checked a few days after completing the antibiotic treatment through a urine test and culture. It is possible for new resistances to develop during antibiotic therapy, which unfortunately cannot be avoided, but it does not necessarily have to happen. Over time, these resistances will diminish as non-resistant individuals become predominant in the bacterial population. As there are still treatment options available to you at the moment and multiple bacteria species have been detected, I still recommend continuing with the current treatment. It can never be completely ruled out that a chronic and asymptomatic urinary tract infection could potentially develop into urosepsis under certain circumstances. The risk of hearing damage during therapy is not very high, which is why treatment is only for 5 days with a dosage of 160 mg. In this case, it is not advisable to combine it with 1 g of aspirin, as there may be additional side effects. A combination with nitrofurantoin is highly recommended, as the second germ is sensitive to it and the combination is easily feasible. You do not need to follow any special hygiene measures and the infection is not contagious.
Best regards, O. Stephan.
