UTI revolving door need advice.
Mom has had a steady succession of UTIs in the last 6 mos. We discovered a kidney stone - which with her being on Pradaxa for A-fib, led to blood in the urine on top of the infection. We saw a Urologist and the kidney stone was pulverized/passed last month, Mom is now having her 2nd infection since the procedure. She developed the first infection after surgery and was prescribed Keflex. (Her immune system is resistant to many antibiotics due to a prior long-term prescription for Bactrim after a severe bout of pneumonia.) The infection cleared only to return on the heels of completing the prescription. I've researched this phenomenon learned that it's entirely possible that with the progression of AD, her immune system is on a steady decline and thus, this could be her "normal". I read that MD's may opt to permanently prescribe an antibiotic to keep the infection at bay and I realize that this is not ideal. However, my mom's PCP requires a sample to be cultured each time before she will prescribe an antibiotic. If antibiotics were opioids, I'd get it. But, antibiotics? If part of the normal progression involves a decline in the immune system, I am frustrated that the practice of sample, culture and then prescription has to be replayed over and over. BTW, mom is able to convey whether or not she's having symptoms and in her case, the ONLY sign of an infection is foul smelling urine. Has anyone else experienced this issue of chronic infections being treated with an ongoing use of antibiotics?
If it were me, I think I'd want to bang some heads together - specifically, those of your mother's GP and urologist, possibly with her cardiologist copied in just in case alternative heart px's might help. Since they're doing cultures (hurrah!) and quite correctly having a care for responsible prescribing (not before time!), they know what bug this is. So while one can appreciate that in someone with your mother's complex co-morbidites they wouldn't want to get too aggressive about it, surely it's worth investigating how they might target and eliminate the particular beastie that's causing this infection.
Meanwhile, you can deal with diet - yes, probiotics/prebiotics AND cranberry juice if she likes it or cranberry extract capsules if she doesn't; hydration - find something she's happy to sip at all day long and keep prompting, because thirst really does seem to diminish along with brain function; and hygiene. With luck a many-pronged attack will get her infection-free, and then you can work more easily on prevention.
It's best to manage your own expectations of what is achievable, though. Controlling her A-fib won't be doing her kidneys any good, alas; but by this stage of life it's very often the case that you have to balance one risk against another and go for the least bad choice. Your mother's PCP sounds like a conscientious and conservative type, which is a good thing; but don't be afraid to keep pushing her (politely, of course) to consider all the options.
Btw, and just for clarity, immune systems don't become resistant to antibiotics, bugs do; and antibiotics can also trash gut flora and impact on other vital functions too. But it certainly is true that the immune system gets increasingly lackadaisical with age; plus it's one of those oh-gawd-help-us ironies that treating a uti with an antibiotic can often cause diarrhoea, which makes effective hygiene next to impossible, which feeds back to another uti... and round and round and round you go.
These UTIs are a real problem
While mom would get them at home she now has them nearly continuously since she's been in a memory care facility due to inadequate hygiene
Often her mood is the indicator she has one and then we wait several days for testing and the culture - the last two times the doctor switched from bactrim to levaquin
At 93 it is just so hard to maintain any normalcy
We were also in the culture, test, prescribe cycle. This last visit, he gave us a prescription for us to fill and have on hand for the next infection and instruction for us to let him know if we had to start using it.
You can buy at home UTI test strips that will help keep you ahead on infections.
The urologist discussed putting her on a daily antibiotic, but, my mom has not decided if she wants to go that route yet. The doctor recommended lots of water and cranberry juice. While my mom says she drinks a lot of fluids throughout the day, I don't think it's true. I'm not sure if that really would help or not, but the doctor seems to think it would. The thing with the antibiotic is that you really need to drink A LOT of water when you take them. My mom doesn't and they make her feel bad.