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Should I restart antibiotics for recurrent urinary symptoms after E. coli infection?
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Kidney & Urinary Health
Question #30057
27 days ago
79

Should I restart antibiotics for recurrent urinary symptoms after E. coli infection? - #30057

Client_e4a544

I was seen on the 10th for urinary symptoms. My dipstick was negative, but the urine culture came back positive for E. coli (10,000–49,000 CFU/mL). I completed 5 days of nitrofurantoin and initially improved, but symptoms returned a few days later. I’m currently having urinary frequency every 2 hours and mild abdominal discomfort. Since I don’t see urology until Tuesday, should I restart antibiotics?

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Doctors' responses

Dr. Bharat Joshi
I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.
26 days ago
5

Hello dear See as per test results it seems presence of infection due to Bacteria White blood cell Probably diagnosis includes Uti infection preferably pseudomonas Glomerulunephritis Nephrotic syndrome Bladder issue Iam suggesting some tests Please share the result with urologist in person for better clarity Cbc Esr Serum ferritin Serum tsh Serum hb Rft Lft Gfr Serum creatinine Serum bilirubin Hemogram Urine analysis Urine culture Kidney USG Hopefully you recover soon Regards

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Before restarting antibiotics, it would be wise to consider a few key factors in your situation. Given that your symptoms returned after completing a course of nitrofurantoin, it’s possible that the initial treatment was inadequate or that you’re dealing with a recurrent or resistant infection. Restarting antibiotics without confirming a current infection could lead to inappropriate treatment or antibiotic resistance, which is best avoided. Firstly, it’s essential to have a repeat urine culture to confirm if the same organism or another pathogen is causing your current symptoms. You should reach out to your primary care physician for an evaluation and request a repeat urinalysis and culture. This can help clarify whether there is an ongoing infection that requires a different antibiotic. In the meantime, stay hydrated to help flush your urinary system, and avoid bladder irritants like caffeine and alcohol. If your symptoms worsen, such as developing fever, severe pain, or blood in the urine, these would necessitate urgent medical attention. While waiting to see urology, if the discomfort becomes unmanageable or signs of a systemic infection appear, you should seek immediate medical care. Always use antibiotics under the guidance of a healthcare professional, as indiscriminate use might complicate treatment effectiveness. This approach ensures your safety while appropriately managing your symptoms.

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