My 89-yr-old mother was diagnosed with a UTI yesterday by her PCP's PA. They only did a dipstick test and I'm not sure how accurate that test is. This was his first time ever seeing Mom so I'm not sure how much he knew about her cognitive impairment.

Mom never complained of any pain like you thought a person with a UTI would have. She was really lethargic and sleeping a lot. She has lost over 20 lbs in the last 6 months going from 138 to 117 and still losing. She has no appetite and eats very little.

I detected a strong odor from her urine last month and contacted her doctor's office and was told to "make an appointment". It was the holidays so, consequently, no appointment was made.

My question is: Do you think it is possible that she really does not have an infection and that the "stuff" they saw in the specimen yesterday could have been there due to poor hygiene (wiping back to front, for example). Mom had showered the night before the appointment, but she does wear pull-up undergarments 24/7 and the night version is usually soaked and heavy the next morning. Plus, her bloodwork came back with a white count in normal range.....high end of normal but still "normal". Can you have an infection without having an elevated white count?

The PA prescribed 250mg of Cipro twice a day. That drug really worries me for a woman Mom's age and with her cognitive impairment. It has so many bad side effects for the elderly (and younger people, too!) I emailed my concerns to the PA and, to placate me, he called in Macrobid for her instead. If it turns out she really does not have a UTI, she does not need to be taking antibiotics. They will do another more detailed urine analysis on Tuesday when she sees her regular PCP. I am not sure whether to stick with the original Rx (Cipro) or go pick up the Macrobid. You would think the PA would have taken everything into consideration before prescribing the Cipro. Once again, I butt in and am not even sure I know what I'm talking about and he changes the Rx.

Has anyone had any experience with an elderly loved one taking either of these medications or being diagnosed with a UTI when they really did not have one?

When my Mom had a UTI the antibiotic made her do a 180. Shevwas to be released to rehab. Thats what they kept telling me everytime I went out to the desk to complain. My Mom's breathing was irregular and her pulse ox was 90. I finally got them to call the doctor and he got her an extra day. My RN daughter left work to see what was going on. Turned out, the antibiotic had penicillin in it and the hospital records showed she was allergic to it. As soon as they changed the antibiotic she perked up.

My daughter explained that while waiting for culture the hospital will use a broad spectrum antibiotic. In moms case, somebody didn't check her records which are updated every time she is admitted.

Is Macrobid the OTC that some members have recommended?

Moms last UTI they catherized her and got every bit of urine out. They then started her on a probiotic and cranberry tablets. (not juice has sugar) Make sure cultures are done so they get the correct antibiotic. Her LTC kept up with the probiotic and cranberry tablet. From Oct to the nxt Sept, when she passed, she never had another UTI.
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Reply to JoAnn29

I recommend a good probiotic and probiotic rich foods and beverages when anyone at any age has to take antibiotics. They are not discretionary, they kill all bacteria, that is why she has diarrhea. Her system is already battling something and then her friendly bacteria is wiped out.

Kefir, kombucha, yogurt, raw sauerkraut, kimchee are good foods that have pre and probiotics, then I would get a good probiotic tablet and give her 2 a day for a week to get things heading in the right direction. Be sure and give the tablets 2 hours either side of the antibiotic. That way both can do their jobs.

I hope she feels better soon.
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Reply to Isthisrealyreal
texasrdr22 Feb 1, 2020
Isthisrealyreal, thanks for the suggestion. I firmly believe in probiotics and was remiss in not having Mom take them along with the Cipro. Thankfully, she has finished the 7-day course of Cipro but, as unfortunate timing would have it, not only did she get the antibiotic-caused diarrhea, she also had the same side effect from the oral contrast they gave her for an abdominal CT which was performed on the last antibiotic day! Double whammy! After 3 days of it, she seems to be nearing the end of the watery stool part, thank goodness. I will pick up some probiotics and start them tomorrow.
My daughter used to work in an ALF and told me that the elderly can act "crazy" when they have a UTI and do NOT present with the same type of symptoms we get when we're younger. They don't have to pain, burning, etc. just mostly behavioral symptoms that are unexplainable.
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Reply to againx100

texasrdr22, usually it takes 3 days for test results to come back, as the doctor needs to culture the test. In the mean time, one is put on antibiotics, then after 3 days either different meds are prescribed or the doctor keeps the person on the original antibiotics.

I had a UTI a couple years back, my clue was every time I got up from a sitting position I had to make a made dash to the bathroom. That in itself was tiring. Then I started to feel hyper like something was wrong. Then delirium was starting, so off to the ER we went. I was in "observation" for two nights with the delirium getting worse. I was delighted when the culture came back, the meds were changed, and I was sent home. That was my case.

For my Dad, when he was complaining about seeing ants on the wall and in his food, I had a feeling he had a UTI. Sure enough he did.

So it affects everyone differently. And the meds can vary greatly depending on what is found in the culture after 3 days. If you want a 2nd opinion, take Mom to an Urgent Care as they run such tests.
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Reply to freqflyer
texasrdr22 Jan 31, 2020
Thanks for the info! After Mom had taken about 6 days worth of Cipro, she had an abdominal CT scan with both oral and IV contrast (nothing to do with the UTI). About 3 hours after we returned home, she developed explosive diarrhea. She had more than 3 bouts that day and was up at midnight and 6:30am and 1pm with diarrhea episodes. In between the visits to the bathroom, her undergarments were soiled. I don't know if it was the Cipro or the oral contrast that caused this problem. Everything I've read said that Cipro can cause diarrhea after about 6-7 days taking it.

My concern is that she might have C. diff. She is not running a fever nor does she have any stomach pain or cramping. Her PCP says give her immodium, but I want her to get the contrast out of her system, too.

I am feeding her a clear liquid bland diet (along the lines of BRAT). At her doctor visit on Tuesday, he prescribed Megace to maybe stimulate her appetite. Also told me it was e-coli that showed up in the culture.

I still think the Cipro was way too powerful a drug to prescribe to an almost 90-yr-old woman with cognitive impairment. And now the diarrhea may be the evidence of that. I'm just praying that it is NOT C. diff.
My Mum is 85 and had her second in her life UTI last summer, the first was 56 years ago. Mum does not have dementia. She did not have any classic UTI symptoms. She had strong smelling pee and pressure in her groin. She did not have a fever, but was tired and lethargic, which is rare for her and she is very active.

I convinced her to go to the doctor and he was surprised that the dip stick was positive as she was pretty much asymptomatic. She did her course of antibiotics, I do not know which one, and has been healthy since.

So yes, a person can have a bladder infection and not present the usual symptoms.
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Reply to Tothill

The elderly are a whole different animal than a 'healthy' younger person.

I am currently txing my 2nd UTI in my whole life! I will NEVER make light of someone with a UTI. I have been miserable all week and it took me hitting the internet hard with my symptoms and 2 sleepless night, up every 1/2 hr to pee to realize I was SICK.

Did and in home test and it came back positive, saw the doc yesterday and that sample came back a "hot yes" meaning the leukocytes and nitrites were off the charts. I wasn't crazy, but I was crying everyday and that is NOT me.

Bactrim for 3 days, then maybe a 2nd run of something else if Dr. thinks it appropriate. I am immuno-compromised due to last year's chemo for cancer. I forget, from time to time, I am NOT a truly healthy specimen, for all that I am in remission, I'm still 'sick'.

So glad I didn't get 'crazy'--as my MIL does. My mom has frequent UTI's and the only symptom for her is horrible smelling urine. Every one is different!

Dr actually gave me a 'choice' of antibiotics, but I am not familiar enough with them to have weighed in. I'm responding quickly to the Bactrim--so good to know for future reference.

I do know that repeated infections txed with the same antibiotic will begin to not work after several times. Make sure you are seeing the same dr or at least that whomever she sees has her whole 'history'.
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Reply to Midkid58
texasrdr22 Jan 31, 2020
I am glad you are feeling better. My concern for Mom was that she was displaying NO symptoms except increased urination and lethargy. She slept most all day. When the PA did the dip stick test, there were leukocytes but no nitrites! And there was not an elevated white count when the bloodwork came back. I know the only thing my Mom ever mentions as causing her pain is her back, and she rarely mentions that. She never complains about anything! I wonder if she is unaware of some types of pain or unable to express feeling pain.

I am confused about the presence of an infection without an elevated white count. With this "new" healthcare system, it is difficult to get any answers from the PCP as he is always in a rush to move on to the next of his patients during his totally over-scheduled day! There is even a sign posted in his office saying he can only consult with you about 2 things on a visit!! Huh?? He is a geriatric specialist, for heaven's sake! How many people in that age group only have 2 things wrong with them??
texasrdr22, it is extremely common for the elderly to have a no symptoms and yet have a UTI, as in the case with my MIL who was getting at least one every 2 months in her NH. To my knowledge they have never put her on anything as strong as Cipro. You are correct that Cipro has been in the news as issues with it have been coming to light, even for non-elderly. I'm not familiar with the other med you mentioned. I know my 90 yr old mom had a side effect from Clindamycin (it caused her lower legs to swell). If I were in your shoes I would opt to give her the other antibiotic until you get a definitive diagnosis, then have another discussion with her doctor about appropriate meds and possible side effects. Also, it may not be her last UTI, so you will need to be on the lookout for behavior changes as that is often the only symptom. Good luck, I hope she has a speedy and full recovery.
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Reply to Geaton777

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