UTI - Dr prescribed Macrobid - Safe? - Also Dr Recomendations

[Anonymous]

Background - I just starting going to women to women at VHC and am 10 weeks pregnant. My UTI test came out positive. They took a week to get back to me and prescribed my Macrobid. I am still breastfeeding my 11 month old.

In doing some research I have read that Macrobid is not recommended for nursing moms - that's the first x against this dr. Then they took a week to get back to me - second strike.

What should I do - will cranberry juice work to keep the infection at bay or eliminate it? I'd rather have a natural treatment. What other antibiotics are out there that could help and are safe for both my older child and in utero? I heard Ampicillan, but don't know that much about it.

Also, any recommendations on a better practice. I'd like to stay at VHC and have a natural childbirth. Or do you think the issues I've faced are just a fluke? I really like Dr. Williams when I was there.

Thanks!

[Anonymous]

Cranberry won't get rid of the UTI. It is good for prevention, but once you have the infection, you need an antibiotic. Macrobid is in pregnancy category B, so it should be safe: http://www.drugs.com/macrobid.html unless you are in your final 2 weeks of pregnancy, which you are not. I will tell you that I had a number of UTI's for my first pregnancy, and took a couple different kinds of antibiotics. I am pretty sure I took Macrobid. So girl, don't wait any longer - get yourself on that antibiotic and start feeling better. The UTI probably wouldn't respond to Ampicillin, just speaking from personal experience.

Now, the fact that the office took a week to respond to your question is a whole other matter. I would think about switching for that reason alone, unless it was a one-time mistake on their part. You said you really like the doctor, so you may want to give them another chance.

[Anonymous]

I love Drs. Elliott and Lashgari, also at VHC, if you are thinking of switching.

[Anonymous]

I have recurrent UTIs and a history of kidney infections, so my OB prescribed a low-dose of antibiotics that I take on a regular basis to prevent them. She said it's much better to prevent them during pregnancy and that macrobid is safe.

I can't speak to the safety during breastfeeding, or VHC docs, but I think the risks of not treating the UTI and having it go further into your kidneys is worse (speaking from first-hand experience).

Good luck!

[Anonymous]

There are several antibiotics (at least?) that are ok for pregnancy/nursing. I had a case of UTI and mastitis while nursing, and was prescribed keflex (or something like that). Cranberry never helped me much (I am very prone to UTI's), and I think the PP is right that it only helps with prevention, it won't treat the infection. No one wants to put extra drugs into our systems while pregnant, but keep in mind that sometimes the harm from the underlying condition (ie infection in this case) could be potentially worse to the baby than the medicine. Good luck to you.

[Anonymous]

I've had one UTI so far and was also prescribed Macrobid. I did a little bit of research, and from what I found, it is the preferred antibiotic for pregnant women. The PPs are correct - cranberry juice can help prevent UTIs, but won't do anything once you are infected. So I would take the Macrobid - it may make you a bit nauseous, just a warning.

I've been seeing the docs at Women to Women for about the past 6 weeks, after switching from 2 previous practices and I really like them so far. Last time I was there (which was just following my UTI, which was diagnosed at a prior practice), I asked the doctor before I left if my urine was clean, and they quickly tested it and let me know that my UTI appeared to have cleared up. I've found that you just have to ask sometimes rather than wait for them to tell you things unfortunately.

The issue with delayed test results seems to be a problem in most places. The last practice I went to actually LOST my bloodwork and I didn't find out until my next appointment (a month later). The bloodwork was for a possibly serious issue, so that was the final nail on that coffin and I switched to Women to Women.

[Anonymous]

OP here. I just talked to the nurse at women to women and she said that I should definitely not take Macrobid since I am nursing. It turns out that Dr. Williams called in the prescription and she knows I'm pregnant and breastfeeding! That doesn't give me a good feeling.

Anyway, the nurse is going to get back to me to see if I can try to reduce the calorie count through cranberry juice or pills. She's also going to look into what other antibiotic I could take and what the risks are to a wait and see approach since I'll be trying a natural method. We'll see. She was really nice.

I'm feeling a little bit better about it. Thanks for the advice. =)

[Anonymous]

Cranberry can help eliminate some urinary tract infections, for some women. Certainly there is no risk in taking it. Make sure you buy 100% pure cranberry juice (the stuff that makes you cringe and choke when you drink it). If need be, put 1 or 2 oz in a cup of water to dilute it a little so you don't gag too much. Depending on what type and how strong the infection is, it may do anything from not help at all, or clear it completely. Either way, it's not going to hurt so you might as well.

[Anonymous]

As someone who delivered prematurely due to a raging case of pyelonephritis (kidney infection) that started as an innocent UTI, I urge you not to treat with cranberry juice. Use an antibiotic and kill the bacteria before it gets worse. Pump and dump if you have to for two weeks, it won't be the end of the world. Pregnant women are very susceptible to UTIs and kidney infections.
Please - learn from my experience. Things can go downhill quickly with UTIs.

[Anonymous]

Totally agree with PP. And I would talk to a doctor and not a nurse if possible before deciding what to do.

[Anonymous]

There is no proof that cranberry juice can cure UTIs. Check this out: http://www.newsweek.com/id/107229

[Anonymous]

Anonymous wrote:Cranberry can help eliminate some urinary tract infections, for some women. Certainly there is no risk in taking it. Make sure you buy 100% pure cranberry juice (the stuff that makes you cringe and choke when you drink it). If need be, put 1 or 2 oz in a cup of water to dilute it a little so you don't gag too much. Depending on what type and how strong the infection is, it may do anything from not help at all, or clear it completely. Either way, it's not going to hurt so you might as well.

You don't even need the juice. You can buy cranberries in a capsule, like a dietary supplement.

[Anonymous]

Well, sorry, but the nurse is wrong (or you didn't tell her your babies age) and your doctor is right. Nitrofurantoin=Macrobid is not advised in the last weeks of pregnancy and when breastfeeding a NEWBORN! - did you not write that your baby is 11 months old?

The point is really that after one week has passed the UTI can have cleared up by itself, so abx may really not be needed anymore at this point - you should repeat a test for uti at your doctor's- and the result should be available immediately - honestly it only takes 10 seconds to read the strip.

See below for info from the NIH:
Administration of nitrofurantoin directly to infants under 1 month of age and in those with G-6-PD deficiency is contraindicated because of potential hemolysis in these infants. Nitrofurantoin doses in milk are low and it can be used while breastfeeding older infants, but it is best to avoid it in infants under 1 month of age and those with G-6-PD deficiency at any age.

Antimicrobials in pregnancy risk category B include the beta-lactams (amoxicillin, cephalexin, cefpodoxime, cefixime, and amoxicillin/clavulanate) and nitrofurantoin. Nitrofurantoin has the advantage of sparing disruption of normal vaginal flora and consistent efficacy against E coli and Staphylococcus saprophyticus. Nitrofurantoin should be avoided after the 36th week of gestation due to the potential (though unlikely) risk for hemolysis if the fetus is G6PD-deficient and in infections caused by Proteus mirabilis. Beta-lactam use usually fails to eradicate the offending pathogen from the periurethral and perivaginal area, increasing the risk of reinfection.

Nitrofurantoin is excreted into breast milk. In one study, the drug could not be detected in 20 samples from mothers receiving 100 mg 4 times daily (12). In a second study, nine mothers were given 100 mg every 6 hours for 1 day, then either 100 mg or 200 mg the next morning (13). Only two of the four patients receiving the 200-mg dose excreted measurable amounts of nitrofurantoin, 0.3–0.5 µg/mL. Although these amounts are negligible, the authors cautioned that infants with G-6-PD deficiency may develop hemolytic anemia from this exposure (13).

[Anonymous]

I am the 08:00 PP and I forgot to give you a VHC recommendation in case you do decide to switch: Dr. Norman Armstrong, in Mclean. He is fabulous in every way. I no longer live in the DC area and I truly miss him. I have also heard that his partner, Patricia Bannon, is very good.

[Anonymous]

OP and everyone -- this is a great website for info on medications while breastfeeding:

http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT

or google "LactMed" to get there.

12:20 PP is right -- Macrobid is only really a concern with newborns. I would think the benefit outweighs the risks in this case.