Macrobid, elderly patient with 3rd stage renal disease
My 81 year old parent was prescribed Macrobid as a second round attack on a bladder infection (3 day Cipro 4 weeks previously). Parent has 3rd stage renal disease. 5 days into the treatment, patient had nighttime spike in fever of 103.4. Took to ER next day, fever still 101.3. ER prescribed Cipro and said continue with Macrobid.
I called pharmacy to find out if the meds should be staggered.The pharmacist was shocked that parent had been given prescription for Macrobid and explained why (elderly, kidney disease, antibiotic less effective if can't achieve concentration needed). I researched and found it on the BEERS criteria rated as a potentially inappropriate drug because of kidney issues. I was very concerned and called after hours service and dr. on call said stop the Macrobid since Cipro was more effective and stronger.
MY QUESTION: is the original prescribing doctor clueless? Am I am over-vigilant and wrong? Should Macrobid be given to someone with 3rd stage kidney disease especially when on a 32 ounce daily liquid limit? Which as I understand it makes the antibiotic ineffective (needing to bind to the protein in the urine).
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.