Dr Steven R. Goldstein MD is a top Gynecologist in NYC Approximately two weeks ago, there was an article in the Science Section of the New York Times speaking about drug resistance (actually, in a gastrointestinal situation), which “has scientists worried.” Obviously, Dr Goldstein doesn’t primarily treat gastrointestinal infections (diarrhea, irritable bowel) but many patients often call when they think they have a urinary tract infection.
Antibiotic resistance is a natural occurrence caused by mutations in bacteria’s genes
In the 1940s when penicillin first came out it killed almost all bacteria. Today it kills very few bacteria because many bacteria have become resistant to its use. Inappropriate overuse of antibiotics accelerates the emergence and spread of antibiotic resistant bacteria.
When a patient presents with burning with urination, frequent urination, feeling like one has to go and can’t, suprapubic pain, and sometimes even bloody urine, these are all symptoms of a urinary tract infection. If the patient goes to an “urgent care” or a healthcare provider, many times will do a dipstick of the urine and if it contains a substance called leukocyte esterase, they presume a bacterial infection and will give a broad spectrum of antibiotic that should kill anything that might be present.
As a leading NYC Gyn, Dr Goldstein does not believe that the preferred way to handle a suspected urinary tract infection is to immediately prescribe antibiotics. He prefers a urinalysis and formal urine culture with sensitivities. While this takes fortyeight hours for a result, there are medications (like Uristat, or Pyridium) which are actually urinary anesthetics. They are very effective at masking the symptoms of urinary tract infection. Simultaneously run a urine culture. If the culture is negative, then the diagnosis is sterile trigonitis, which is a condition where the trigone of the bladder becomes inflamed.
Such a situation can be treated with one week of one of these urinary anesthetics and an antibiotic is not necessary. If such a culture and sensitivity shows bacteria being present, then Dr Goldstein likes to choose the least broad spectrum antibiotic for that particular bacterial strain.
Women who have frequent urinary tract infections need to be mindful of frequent use of antibiotics, lest they become resistant to them (Dr Goldstein will comment on this in the next article). If you suspect you have a urinary tract infection, schedule a consultation with Dr Steven R. Goldstein, a top Gynecologist in NYC .
“The information in this article is not a substitute for in office medical advice, diagnosis or treatment. The information is provided for informational or educational advice only.