Give me your best care info

[Cheshire]

My 4.5 is on his fourth round of antibiotics for a UTI. Each time they've cultured his urine they've prescribed an antibiotic that the bacteria (E. coli) is supposed to be sensitive to (not sure the "technical" phrase for that).

His pediatrician wants me to take him to a urologist. I haven't been able to get a personal recommendation for one yet. So, I took him to our family doc yesterday just to see if he might have a recommendation.

Well, let's just say I got my practice at saying "it's not an option." If it weren't for the fact that I got practice standing up for my boy I would say it was a COMPLETE waste of time.

So, before I take him to a urologist I want to have a few articles about how the unretractable foreskin is self cleansing, how it doesn't harbor bacteria, etc. Anyone have any good sources???

I just wish this wasn't such an uphill battle. Thanks in advance!!!

[kiara7]

I'm not much help with links, but what abx has he been on? (if you don't mind)

[Cheshire]

Forgive my spelling - Bactrim, amoxicillin, augmentin (I think it was augmentin) and now back on Bactrim.

[kiara7]

Has anyone suggested Keflex (cephalexin)? The ones you listed are more of a "general" antibiotic, where as Keflex targets Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, E. coli and several others.

I'm sure someone will come along with care links, but if you're going to a doc or a urologist, I would request Keflex rx. Also, I would rethink his ped, if he keeps on getting an E.Coli culture but is not prescribing a more specific and effective abx in this case.

Good Luck!

[Night_Nurse]

Originally Posted by Cheshire

His pediatrician wants me to take him to a urologist. I haven't been able to get a personal recommendation for one yet. So, I took him to our family doc yesterday just to see if he might have a recommendation.

Have you check out this doctor? This info was at the bottom of your thread from 1/28:

Dr David Ewalt
Urology Clinics Of North Texas
8315 Walnut Hill Ln Ste 205
Dallas, TX 75231

Phone: [phone]
Fax: [phone]

This is a wonderful pediatric urologist. He performed surgery on my son when he was 7 months old. He has absolutely no issues with intact boys & will not recommend circ for infections. He can be hard to get an appointment with though.

[Cheshire]

Ah, thank you NightNurse. That info was posted on Tuesday and I hadn't checked the other thread again.

I'll give him a call!

[Cheshire]

Thanks for all the info. Dr. Ewalt couldn't see him until March and wouldn't see him unless he's had a VCUG done (he's already had an ultrasound that was normal).

I went ahead and took him to the urologist his ped recommended. They were able to get him in the next day. He suggested a VCUG, but he did say that in 60% of cases the VCUG comes back normal. I told him before we did any invasive tests I wanted to try another round of antibiotics, that DS's symptoms have never cleared up, even on the antibiotics, and I thought the ones we've tried just haven't worked well enough.

After looking at the reports on all of his urine cultures he agreed with me that we probably just haven't cleared up the first infection. He showed me all of the reports and the list of the antibiotics the cultures were susceptible to (and one was resistant to a "cillin" antibiotic - can't remember which, it was the culture right after he finished a course of amoxicillin).

I asked about Keflex and he said the antibiotics we've tried target just the bladder. He said Keflex would affect the bladder, bowel and skin. He said the E. coli could have colonized under his foreskin and the Keflex could help. He prescribed him a 6 week course to see if we can knock it out. He actually suggested probiotics.

He also said in countries that don't do routine circumcision a recurring infection, like DS might have, would be a cause to circumcise. : But, he did say that if the infection was not caused by the foreskin and you circumcise the problem is you can't put the foreskin back.

So, we're taking it one more step at a time. Keeping our fingers crossed that this clears it up. If not, then we'll cross that bridge when we come to it. He suggested a VCUG if this didn't get rid of it. We'll see.

He also said that the foreskin usually only causes problems at the ends of a lifetime - as infants with infections and as old men.

Overall, it wasn't awful and I think we were heard. I do know that if this doesn't clear it up we'll continue to find a more intact friendly doc. Circ is not an option.

Thanks again to everyone for your help!!!

[kiara7]

Awesome!

I hope everything gets cleared up fast! Jic, give probiotics 2-3 hours after abx.