Winning the Battle Against UTIs

New techniques and technology help prevent and treat urinary tract infections.

Fighting to prevent and treat urinary tract infections (UTI) seems to be a never-ending battle for wheelchair users.

However, new techniques and technology continue to be developed to win that fight. Research into UTI also continues to give doctors better information on how and why they develop.

The goal of good bladder management goes a long way toward keeping those with a spinal-cord injury in good shape for the present and future. Sometimes prevention boils down to good old-fashioned common sense. However, there are also times when not-so-common knowledge can make a difference to keep someone healthy.

Good Bacteria

If you’re managing your bladder with in/out catheters, an indwelling Foley catheter, or an open collection device, you will have bacteria in your urine. This is expected and doesn’t mean you have a bladder infection.

However, if you develop fever, fatigue, chills and/or increased spasticity and have white blood cells in your urine, you have a bladder infection that needs to be treated.

Many people have a bladder infection one or two times a year, but the goal is to colonize good bacteria in the urine that don’t cause bladder infections. This is possible if you’re able to stay out of hospitals, away from antibiotics (which tend to select the “bad” bugs), and use a good catheter-management program.

Get Away From the Cycle

Another study tested the aggressive use of antibiotics to clear the bladder of all bacteria on the theory that sterile urine would lead to fewer UTIs. However, the patients had just as many UTIs and needed intravenous antibiotics more often to treat infections.

The use of low-dose preventive antibiotics may be needed to get away from a recurrent cycle of infections. Addressing any problems with your catheterizing technique can be helpful.

Often, switching to Betadyne to clean the bladder opening can prevent bad bacteria from being introduced to the bladder when you place the catheter.

Many antibiotics can be used to treat bladder infections. Often your doctor will treat your bladder infection empirically (without a urine culture), but the only way to be certain you’re treating the right bacteria with the right antibiotic is to get a culture.

There are several antibiotics interactions to be aware of, and it’s important to inform your doctor or pharmacist of all the antibiotics and over-the-counter medications you’re taking so they can screen for interactions.

There are two biggest concerns in this area. One is the use of Tizanadine (Zanaflex) with Ciprofloxin (Cipro), as this combination can affect your heart rhythm. The other is the use of Methenamine mandelate (Mandelamine) with sulfa antibiotics (Bactrim or Septra), which can result in crystals forming in your bladder.

However you’re managing your bladder, you should be able to achieve good control with minimal leakage and infections. If you’re struggling, discuss this with your physician and seek some help.

Reprinted with permission from The Spinal Connection, Fall 2012, a publication of the Arkansas Spinal Cord Commission (spinalcord.ar.gov).

 

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