How to treat Renal haemorrhage when not responding to Amoxicillin and Macrodantin?
Patient: I am a 66 year old female born with one kidney but I ve never had any problems with it prior to August 17th, 2013. I had open heart surgery scheduled and had to start taking 3 medications including Coumadin. I began to have a lot of blood in my urine and I developed a UTI. I was given some strong antibiotics but had renal hemorhage 2 days later which required a four day hospitalization. The surgery was delayed a month for my kidney to heal. On September 17th 2013 I had successful open heart surgery (valve repaired/valve replaced/epicore maze) and I have been ok until about 2 months ago when I started having UTIs again. Tests have shown leukocites esterase, nitrates, protein and blood. My urine is brown right now and burns. They are treating me with amoxicillan and then macrodantin but I have not responded to either of them. Due to the hemorhage after the stronger meds were prescribed, they feel those two are the strongest things I can take but it is not working. Do you have any ideas? Doctor: Hello and welcome to HCM.As an Urologist, i must advise you, that before starting treatment for UTI in future, always get an urine culture done.  It's more sensitive than nitrates in urine.  The other reason being,it tells us,which is the best antibiotic to use.Don't worry about being born with one kidney,  as it's seen in many people.Your doctor may change the antibiotic, to a cephalosporin soon.  In active bleeding, your aspirin/ Clopidrgel/ Coumadin, would've been stopped by your cardiologist.  Your prothrombin time,INR,and platelets must be checked periodically.   If you need an expert opinion,you may contact me directly.Dr.Matthew J. Mangat.