How long is too long for antibiotic usage

[Ray__0]

  Hello,
  I am a 50 year old male.  Six weeks or so ago I got a UTI.
  While I realize this is rare for a male, I know the reason
  why it occurred and that is not the issue in my question.
  Its symptoms were simply feeling rotten in general and
  cloudy urine - no burning or urgency.  My family practice
  physician put me on 800mg Septra DS twice a day for 10 days.
  However, about 3 weeks after I quit taking it one of my
  testicles became sore, swelled up, and I got cloudy urine,
  blood in my urine, and blood in my semen - but no burning or
  urgency.  So I am thinking, "this is probably a prostate
  infection".  In any event, I went to see my urologist who
  put me on a course of Cipro.  He said that 10 days on
  antibiotics is often insufficient so he prescribed 500mg
  of Cipro twice a day for the first 10 days then 500mg of
  Cipro once a day for 50 more days.  This is a total of 2
  months on this antibiotic.  After about 5 days on it
  everything started to get better and the painful part of
  the swelling went down, although I understand that
  getting back to normal size can take several months.
  I would simply like some information on the side effects of
  being on this medication that long.  The PDR indicates that
  prolonged useage might affect the kidneys.  I am also concerned
  about possibly building up an immunity to this drug or others
  in the same family.  Since I am totally medically uninformed,
  any opinions on anything pertaining to what I have mentioned
  will be appreciated.
  Thanks,
  Ray
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Dear Ray,
Your concerns regarding long term antibiotic use in regards to development of resistant organisms (bacteria) and possible side effects are legitimate.  Although what you initially described sounds like a UTI (urinary tract infection), what you later describe 3 weeks after the initial antibiotic course sounds like a UTI with involvement of the epididymis/testis (epididymitis, orchitis) which require a longer course of antibiotic treatment.  In general, the choice of antibiotics is at the discretion of your physician, but we usually start with the least expensive and safer antibiotics, and save the ‘big gun’ antibiotics as a last resort to treat resistant organisms.  Septra is a “sulfa” antibiotic which is good for treating infections of the urinary tract including epididymitis and prostatitis.  Ciprofloxacin is a type of flouroquinolone antibiotic which is excellent for infections of the urinary tract, including epididymitis and prostatitis.  It has a wider spectrum, and has good penetration into prostate tissue, and the course of therapy depends on the type of infection.  There is however a higher resistance associated with flouroquinolone use and therefore administration of these antibiotics as with any antibiotic should be judicious.  An uncomplicated UTI can be treated anywhere from 1 to 5 days, although current recommendation with either Cipro or Septra is 3 days.  An infection of the prostate may be treated with 4 weeks of Cipro 500mg twice a day or 6 weeks of Septra twice a day. Since urinary tract infections are rare in males, you may require further follow-up and possible work-up and tests in the future to rule out any other possible cause (such as an infectious stone).  Therefore, keep in contact with your urologist in case you develop recurrent symptoms after this.  Wish you the best,
This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
Sincerely,
HFHS M.D.-JJ
*Keyword: UTI and ciprofloxacin

[35andConcerned]

A related discussion, Should I be worried about getting an infection during surgury after stopped taking antibotics for two months? was started.