Refused treatment for UTI

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.

I was asking what PP meant by writing what was written. It's not an insult, but you seem to be taking offense. Why so defensive?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.

I was asking what PP meant by writing what was written. It's not an insult, but you seem to be taking offense. Why so defensive?

You really cannot understand what the PP wrote?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

But it seems like op could not get her doctor to,do,a urine test for several days

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

For a UTI that was confirmed by urgent care? How is that a problem for you?

It’s not confirmed until there is a culture. I was getting urinary pain every couple months about 8 years ago and it was NEVER actually a UTI. We shouldn’t be taking antibiotics at the drop of a hat because it wasn’t helping me and it was actively harming the rest of the population. Never did figure out what was causing the pain, but it all ended up resolving on it’s own.

[Anonymous]

Anonymous wrote:Next time go to a walk-in clinic or an urgent care clinic, not the ER, for a minor emergency like a UTI.

Dp I've had them and it does not feel "minor" when you are going through it. Sure it isn't a gun shot wound but, it is painful and I don't like your dismissive attitude. The last time I had one I went to a clinic and they gave it right away after i described my symptoms.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Clinics have definitely been cracking down on prescribing antibiotics for UTIs with the urine culture. This will be particularly true if you are a middle aged, or older, woman because you can have UTI symptoms that are not caused by bacteria. I have had a urine culture that came back negative. I both think it is responsible for providers to see the urine culture before giving out antibiotics, and I get how frustrating it is as the patient to be waiting for days to get relief.

This. I can't believe you wouldn't respect a provider being responsible. I have chronic UTIs now (thank perimenopause). So I got in, leave a sample, then head right to CVS to get some Uritstat. It starts working really quickly and gives me pain relief. Then I wait a day or maybe 2 for the culture to come back. The reason we have to do this is because of patients like OP who is demanding antibiotics STAT.

For a UTI that was confirmed by urgent care? How is that a problem for you?

It’s not confirmed until there is a culture. I was getting urinary pain every couple months about 8 years ago and it was NEVER actually a UTI. We shouldn’t be taking antibiotics at the drop of a hat because it wasn’t helping me and it was actively harming the rest of the population. Never did figure out what was causing the pain, but it all ended up resolving on it’s own.

mine are caused by small kidney stones passing

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP I have a ton of experience with UTI's and no your doctor should absolutely be able to culture and tell you within minutes whether you have one.

Get a new doctor.

Also, CVS Minute clinics and or any urgent care would be better than your current doctor. They are idiots.

If the longer culture comes back negative then they should send you to a URO GYN not no antibiotics. There would be an underlying reason for the pain.

Are you saying that the culture results can come back in minutes, or am I misreading you?

I think they mean the doctor’s office can determine if bacteria is present in the urine during the office visit. The actual culture to see how the bacteria reacts to the antibiotics is not immediate.

Thanks, but I was trying to determine what PP meant by writing that, and I'm still interested in PP's response.

What are you “trying to determine”? Are you conducting an investigation? It’s quite clear what PP meant.

I was asking what PP meant by writing what was written. It's not an insult, but you seem to be taking offense. Why so defensive?

You really cannot understand what the PP wrote?

I'm not clear if PP understands what a "culture" is, as opposed to a UA or dip. There is reference to a "culture and tell you in minutes" and then a "longer culture" mentioned in the same post. And if PP doesn't understand the difference because they don't really understand the words they are using, then they can't understand discussing the pros and cons. They are using the wrong words to make sense of it.

If you think you understand what PP means, what is a "longer culture?"

[Anonymous]

I just want to chime in as someone who frequently had UTIs before drastically cutting processed sugar in my diet that the pain was very far from "minor" for me and symptoms sometimes included fever and nausea. Every single one felt horrible.

[Anonymous]

I'm a nurse practitioner and treat UTIs. The person you saw may have practice guidelines she is obligated to follow (like waiting for culture results) but here's how I handle these: If someone has mild/vague sx ("I'm peeing more frequently" or "my pee has a weird smell") but not acutely uncomfortable I will send the culture and then treat based on results. That is a day or 2 turnaround so reasonable if suspicion is low/symtpoms are mild. However if symptoms are classic for UTI and/or patient is very uncomfortable I will go ahead and treat with one of the first line recommended antibiotics at time of visit. As someone said above most UTIs are caused by E.coli and we have a good handle on which meds they are most likely to respond to.
Someone above made point that doctors offices can have culture "in minutes." This isn't true. The thing we do that takes a few minutes is a macro urinalysis which is just one of those little sticks that you dip in urine with squares that turn different colors (for white blood cells, protein, glucose etc.) These can be very helpful in confirming UTIs but they are imperfect and also give us no info about an antibiotic match if that is a concern.
As many have pointed out, in health care we try to be judicious with use of antibiotics and not just prescribe at the slightest of something being not right, much as many patients want that. And things that feel like UTIs can be other things, I have lots of patients tell me they have a UTI and end up with a negative culture. At the same time when someone is experiencing acute discomfort and presenting with classic symptoms I always offer treatment. It's a balancing act.

[Anonymous]

Anonymous wrote:Next time go to a walk-in clinic or an urgent care clinic, not the ER, for a minor emergency like a UTI.

This. Also..I would change doctors. For UTI (especially with obvious symptoms) antibiotics are prescribed right away and then when the culture comes back the doctor can confirm you are on the correct antibiotic or change it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Infections kill people. Infections that hang around untreated while an arrogant, cookbook, insecure, in knowledgeable “health care practitioner” waits for confirmatory labs are more likely to kill people.

Part of the art of medicine is the knowledge, experience and confidence to make a good judgment and begin treatment and then have the diagnosis confirmed or adjusted when the labs come back.

There is no excuse for how you were treated. You need a new primary care PHYSICIAN.

Ok alarmist. Did you know UTIs can clear on their own? Did you know only a small fraction lead to a kidney infection? Most patients can safely wait until the culture comes back with pain relief. Not all but most. It is the pain and discomfort that need to be treat immediately.

Ear infections and UTIs are over medicated. They have pulled back on automatic antibiotics for ear infections and are finally beginning with UTIs.

No, chickens and other livestock are “over medicated.” Read up on Jim Henson of the muppets before you call people names and prattle off the ill informed, bought and paid for, public line that antibiotics are “overused” in the human population. Doctors are “learned intermediaries,” not their patients’ owners.

But then again, the “provider” here wasn’t even a doctor.

[Anonymous]

Anonymous wrote:I'm a nurse practitioner and treat UTIs. The person you saw may have practice guidelines she is obligated to follow (like waiting for culture results) but here's how I handle these: If someone has mild/vague sx ("I'm peeing more frequently" or "my pee has a weird smell") but not acutely uncomfortable I will send the culture and then treat based on results. That is a day or 2 turnaround so reasonable if suspicion is low/symtpoms are mild. However if symptoms are classic for UTI and/or patient is very uncomfortable I will go ahead and treat with one of the first line recommended antibiotics at time of visit. As someone said above most UTIs are caused by E.coli and we have a good handle on which meds they are most likely to respond to.
Someone above made point that doctors offices can have culture "in minutes." This isn't true. The thing we do that takes a few minutes is a macro urinalysis which is just one of those little sticks that you dip in urine with squares that turn different colors (for white blood cells, protein, glucose etc.) These can be very helpful in confirming UTIs but they are imperfect and also give us no info about an antibiotic match if that is a concern.
As many have pointed out, in health care we try to be judicious with use of antibiotics and not just prescribe at the slightest of something being not right, much as many patients want that. And things that feel like UTIs can be other things, I have lots of patients tell me they have a UTI and end up with a negative culture. At the same time when someone is experiencing acute discomfort and presenting with classic symptoms I always offer treatment. It's a balancing act.

Are you only prescribing antibiotics based on the results of the urinalysis? Or are you providing them if the patient is describing severe symptoms?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm a nurse practitioner and treat UTIs. The person you saw may have practice guidelines she is obligated to follow (like waiting for culture results) but here's how I handle these: If someone has mild/vague sx ("I'm peeing more frequently" or "my pee has a weird smell") but not acutely uncomfortable I will send the culture and then treat based on results. That is a day or 2 turnaround so reasonable if suspicion is low/symtpoms are mild. However if symptoms are classic for UTI and/or patient is very uncomfortable I will go ahead and treat with one of the first line recommended antibiotics at time of visit. As someone said above most UTIs are caused by E.coli and we have a good handle on which meds they are most likely to respond to.
Someone above made point that doctors offices can have culture "in minutes." This isn't true. The thing we do that takes a few minutes is a macro urinalysis which is just one of those little sticks that you dip in urine with squares that turn different colors (for white blood cells, protein, glucose etc.) These can be very helpful in confirming UTIs but they are imperfect and also give us no info about an antibiotic match if that is a concern.
As many have pointed out, in health care we try to be judicious with use of antibiotics and not just prescribe at the slightest of something being not right, much as many patients want that. And things that feel like UTIs can be other things, I have lots of patients tell me they have a UTI and end up with a negative culture. At the same time when someone is experiencing acute discomfort and presenting with classic symptoms I always offer treatment. It's a balancing act.

Are you only prescribing antibiotics based on the results of the urinalysis? Or are you providing them if the patient is describing severe symptoms?

I will certainly prescribe based on symptoms alone because the UA macro results that we have immediately aren’t particularly sensitive. It’s always useful to have leukocytes and nitrites confirming a UTI on the spot (so we know it’s not something else) but some people wait until they’re pretty miserable to come in and I certainly don’t want them walking around in agony for two more days waiting for a culture result. But if the symptoms are mild and vague and the UA macro is negative or inconclusive we sometimes wait for a culture because we are always providing better care when we know it’s a good antibiotic match for the situation. And mild symptoms, even if they are UTI, or unlikely to turn into a raging kidney infection in a day or two.

[Anonymous]

I get frequent UTIs. Enough so that my doctor gave me a blanket prescription for Macrobid. Anyway I was in for my annual exam recently and I was pretty sure I had one brewing but the symptoms weren’t all there yet. I asked her to send it out for culture. They did a big analysis right there in the lab during my appointment and told me nothing was there. But I asked to please send it out because I really wanted to know if my suspicions were correct or not. Things got so bad the next day (Saturday) that I went ahead and took my Macrobid anyway. I knew from past experience I was hours away from visible blood in urine.

[Anonymous]

Con’t

On Monday I got an urgent call from the doctor’s office telling me that my culture was indeed positive and I needed to continue dosing for seven days. It pays to know your body. An untreated UTI can lead to kidney infection as well as sepsis. If I were the OP I would change to a different practice or not seen that NP again.