klebsielle pneumoniae in urine not responding to meds

[cocobeen]

I was diagnosed with a Klebsiella Pneumoniae infection in my urine on culture and the doctor started me on Norfloxacin 400 mg BID X 5 days on Monday, November 19th. I have been feeling steadily worse instead of getting better. I saw her on November 20th, and she did not change the medication or prescribe more of it because she said that it was enough for an uncomplicated UTI and gave me a script for Toradol as well as a req to have an abdo xray done and an U/S to make sure there wasn't anything else going on. She did not have the culture back and the chemical analysis only showed blood. On Friday, I was finished the antibiotics and still having immense flank pain and feeling horrible, having to go frequently and on dipstick test at work, the nurse said I was showing 2+ RBCs and trace of protein, which I had not shown on dip at the family doctor's on the 19th. The doctor in the walk-in clinic I work in looked at the sensitivities and decided to try Suprax 400 mg daily for 7 days. I started it this morning and so far no changes. I am still having to go frequently and the toradol and tylenol only hold me for four to six hours pain wise and then the pain is back. I sent another sample off yesterday. How well should the infection respond to the suprax, considering this is the second antibiotic we have tried. I don't understand how I got this infection in the first place considering I haven't been in hospital or anything like that. This is also concerning me because in mid-september I had an E Coli infection in my urine that appeared to clear up just fine. Is there a difference in how the bacteria make a person feel and how long it takes to clear up the infection. I intend to talk to my doctor on monday about this. Thanks for your help

[Kevin Pho, MD]

I agree with the workup thus far.

Normally on the urine culture, there should be culture and sensitivity.  This would determine whether the bacteria is resistant to the antibiotic.  Normally Suprax and Norfloxacin would be tested in the panel.

I agree with the ultrasound to determine whether this is any kidney swelling.

If you are male, further evaluation of the prostate should be done.  Imaging with a transrectal ultrasound and a prostatic massage can be done to send off any prostatic fluid for analysis.

If the symptoms continue, and the bacteria persists, a referral to an infectious disease specialist can be done.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[elena1478]

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