8 days out from normal dose (6mg) and have felt like I have a urine infection. Coming on strong today. Keep skipping dose until recovered? Yes? And which antibiotic do I need? Have taken Bactrim (sulfamethoxazole and trimethoprim) in the past. Any suggestions?
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Methylene blue is very good for UTI.
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Not going to give you specific medical advice, but can talk in generalities. First if you are male - I’d especially not recommend self treatment or diagnosis - as all male UTIs are complicated
If you are female, and there is just urinary frequency and burning, but no fever or flank pain - this would usually be a simple situation of a bladder infection (Cystitis).
It’s important to know local resistance patterns to antibiotics to know which one will work, if I’m treating someone who has a urine test showing evidence of infection and has symptoms.
The range of antibiotics I use includes items like:
Cefdinir, Keflex, Augmentin, Cefuroxime, Nitrofurantoin.
Rarely - if allergies TMP/SMX (Bactrim), Doxycycline, Levofloxacin or Ciprofloxacin.
It is important to note nitrofurantoin gets no tissue levels (so no good for men as we presume prostatic involvement) or for kidney infection (as need a tissue level).
Hopefully that summary is helpful information.
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D-Mannose (@ Amazon) is excellent if it’s a bladder infection that just started. It’s great for prevention too.
D-mannose is a type of sugar that can help treat and prevent urinary tract infections (UTIs), including bladder infections. Here’s how it works:
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Interferes with Bacterial Adhesion: D-mannose prevents bacteria, particularly E. coli, from sticking to the walls of the bladder. This is crucial because E. coli bacteria need to adhere to the bladder lining to cause an infection¹².
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Competitive Inhibition: The free D-mannose in urine can saturate the structures on E. coli that allow them to attach to the bladder wall. This competitive inhibition helps block the bacteria from adhering to the urinary tract cellsÂł.
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Expulsion of Bacteria: Once the bacteria are unable to stick to the bladder walls, they are more easily flushed out of the body during urination².
This mechanism makes D-mannose a useful supplement for both preventing and treating bladder infections. Have you tried it before, or are you considering it for the first time?
Âą: U.S. News
²: Cochrane
Âł: Nutrition Journal
Source: Conversation with Copilot, 9/7/2024
(1) D-Mannose for UTI: Is It a Cure? | U.S. News - US News Health. https://health.usnews.com/wellness/articles/d-mannose-for-uti.
(2) D-mannose (sugar tablets) for preventing or treating urinary tract … D-mannose (sugar tablets) for preventing or treating urinary tract infections in adults and children | Cochrane.
(3) Role of D-mannose in urinary tract infections – a narrative review. Role of D-mannose in urinary tract infections – a narrative review | Nutrition Journal | Full Text.
(4) D-Mannose for UTI: Dosage, Treatment, Side Effects, and More - Healthline. D-Mannose for UTI: Dosage, Treatment, Side Effects, and More.
(5) en.wikipedia.org. Mannose - Wikipedia.
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D-mannose changed my life.
For the right (wrong) bacteria, D-mannose works astonishingly well, and in my experience works faster with fewer side effects than even prescription antibiotic. Many of us can feel a bladder infection coming on before a test will show it; for us, D-mannose is a miracle cure.
But I’m female, and as @DrFraser cautions, men may work differently. (We always suspected. 
)
There are other causes of the symptoms of a uti. So best to get tested.
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The best advice would be to simply make an appointment with your PCP or go to a walk-in clinic if needed. They can take into account your sex, medical history, and other conditions you may have. And they will ask specific questions to help make a reasoned decision. A person’s age, marital status, and sex may change the course of questioning, too. Just as an example, UTI’s in younger healthy men aren’t necessarily rare but are relatively uncommon compared to women, and it might prompt STD testing. And in men past a certain age, the prostate often becomes a point of consideration.
There are people, usually women, who have a tendency to get UTI’s on occasion. And sometimes they’ll be having thoughts for a while of, “I think I might have a UTI again, but I’m not sure. It’s mild.” That may prompt a complete urinalysis with culture, or urinalysis with reflex to culture. Identifying the bacteria allows for what’s called antibiotic de-escalation where treatment is switched from a broad spectrum agent to a narrow-spectrum antibiotic that is specifically effective against the identified bacteria. This helps minimize antibiotic resistance, reduce side effects, and improve the effectiveness of treatment so that a subclinical infection doesn’t persist and reactivate. Otherwise it may help to rule out a new infection based on mild symptoms.
Although, I have to say that many primary care and urgent care doctors like quick dispensation for these reports. And some doctors have a go-to antibiotic. For example, Bactrim. And then wait for someone to come back if it doesn’t work.
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