Be Careful of Antibiotics

A 55-year-old patient presents with complaints of symptoms suggestive of a bladder infection. She states that she has this very frequently. She mainly complains of urgency, frequency and bladder discomfort during urination. She has been treated with antibiotics several times and she notices slight improvement in about 2-3 days after starting the antibiotic and then the symptoms come right back as soon as the course of antibiotics is over. She has gone through several antibiotics over the years and has been grappling with this problem for the past 10 years at least.

She does not recall whether her doctor ever sent the urine for culture. Most of the times, the symptoms come on suddenly over the weekend and she is treated by the local urgent care. The most common antibiotic which is given to her is ciprofloxacin.
When she came to the office, she had the same complaints. She had symptoms of urgency, frequency and also dysuria.
On examination, she was noted to have postmenopausal vulvovaginal atrophy (thinning of the vagina), pain at the opening of the vagina called vulvodynia and also pain the level of the bladder on examination of the bladder.

However, the urine that was sent for culture came back completely negative ( no infection) and the cystoscopy (looking inside the bladder with a telescope) was normal.

In short, this patient had been treated with antibiotics when she actually does not even have urinary tract infection due to bacteria.
This is a classic case of bladder pain syndrome which is managed very differently and antibiotics are never prescribed for this problem.

Giving antibiotics to a patient with bladder pain syndrome can potentially cause complications because of the antibiotics. One of the feared complications of antibiotics is called C. difficile enterocolitis. This is a very dangerous condition where the patient experiences diarrhea, bwelly cramping and sometimes blood in the stools. She has to be admitted to the hospital and placed in an isolation room.

Therefore it is very important to use antibiotics judiciously and not indiscriminately.

If you or a loved one is suffering from these type of symptoms, it is very important to make sure that you consult a specialist such as a urogynecologist and determine whether these are true bladder infections or is there a different disease problem.

The above patient was properly treated for bladder pain syndrome and she did excellent without taking any antibiotics.