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I have had recurrent UTI, even after treatment. What causes it?

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QUESTION: Hello doctor, I have had recurring UTI for three weeks now. I received some treatment, but it seems not to go away. What could be causing this? Should I be worried? Gladyce.

Response: Dear Gladyce,
Urinary Tract Infection (UTI) is a term used to describe acute inflammation of the urethra and bladder, secondary to a micro-organism.

At all times, your urine should be analyzed in three steps: dipping a strip in it (dipstick), visualizing it under a microscope/cytometer and conducting a urine culture to identify the causative organism and drugs to which it is sensitive.

Some UTI causing organisms do not die when treated with antibiotics because they are resistant to most of them.
Recurrent UTI.

If the causative organism persists on repeat culture despite treatment, or if there is a re-infection with any organism after an interval, an underlying cause is more likely to be present.

This may result in renal damage. Therefore, it calls for a more detailed investigation.

If an underlying cause cannot be treated, suppressive antibiotic therapy can be used to prevent recurrence and reduce the risk of septicemia and renal damage.

Urine should be cultured at regular intervals. A regime of two or three antibiotics in sequence, rotating every six months, is often used in an attempt to reduce the emergence of resistant organisms.

Please see a doctor to guide you on the proper use of antibiotics to deal with such resistance as soon as possible.

Other simple measures
To get rid of recurrent UTI, one may also use the following:
– Taking at least two litres of fluid a day.
– Regular, complete emptying of the bladder.
– Good personal hygiene
– Emptying of the bladder before and after sexual intercourse.
– Wiping from front to back after toilet.
– Treat your partner with the same dose as yours to avoid reinfection.
– Stop using spermicides because they kill protective bacteria in the vagina.

Answered by Dr Molino Binywasiki of Mulago National Ref. Hospital.

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