What treatment/antibiotics for prostate stones/UTI?

[Sheryl]

On 6/12/2024 at 1:19 PM, simon43 said:

Well, my trip this morning to the Urology clinic at Pattaya Memorial hospital didn't go well!  Note that my Thai language fluency is such that I'm able to discuss the medical details etc of my problem in Thai.  But in any case, the doctor whom I saw discussed in both Thai and English.

 

Unfortunately, he seemed to be of the "I am an important doctor and you know nothing" type!  He dismissed my history of BPH, prostate calcium stones (diagnosed at the UK hospital last year), MRI at Burumgrad, 24-needle biopsy, long-term UTI and recent urine antibiotic sensitivity test etc, and declared that I mostly likely had a blockage in my urethra and he was going to prescribe an oral antibiotic (which the culture results clearly showed was unlikely to work - he had a copy of these results in front of him).

 

At my polite insistence that a XXXpenem (XXX means there are several suitable antibiotics of the penem family) antibiotic course of injections seemed to be the best course of action, he said that this would probably clear up the UTI but that it would then return because I hadn't had the urethra obstruction removed...

 

He agreed to a course of 5 daily injections of XXXpenem.  Now I had checked the cost of this kind of drug and I know it's expensive.  But the hospital wanted to charge me $125 USD for each injection.....  That price doesn't tally with what Dr Google tells me 🙂

 

I don't want a diagnosis from the doctor - I've already had that.  I just want a competent medical person to administer the course of XXXpenem injectable antibiotic.

 

Can I buy this medicine over the counter?  If so, perhaps I could then go to Dr Olivier's clinic and have him administer it.

No, you can't buy these IV antibiotics over the counter (and would not save much if you did, the drug costs are very high). But If Dr. Olivier is willing to administer it, he can source it for you.

 

Bill is not likely to be less, though. Might even be more -- but I see no point in sticking with a doctor whom you are not comfortable with and does not have a collegial approach. So maybe have a chat with Dr. Olivier.

 

I don't know what you were looking at on Google, but $125 per dose is about average for these drugs.

 

And you'd need more than 5 day course. 10 at least.

[scubascuba3]

23 hours ago, simon43 said:

Well, my trip this morning to the Urology clinic at Pattaya Memorial hospital didn't go well!  Note that my Thai language fluency is such that I'm able to discuss the medical details etc of my problem in Thai.  But in any case, the doctor whom I saw discussed in both Thai and English.

 

Unfortunately, he seemed to be of the "I am an important doctor and you know nothing" type!  He dismissed my history of BPH, prostate calcium stones (diagnosed at the UK hospital last year), MRI at Burumgrad, 24-needle biopsy, long-term UTI and recent urine antibiotic sensitivity test etc, and declared that I mostly likely had a blockage in my urethra and he was going to prescribe an oral antibiotic (which the culture results clearly showed was unlikely to work - he had a copy of these results in front of him).

 

At my polite insistence that a XXXpenem (XXX means there are several suitable antibiotics of the penem family) antibiotic course of injections seemed to be the best course of action, he said that this would probably clear up the UTI but that it would then return because I hadn't had the urethra obstruction removed...

 

He agreed to a course of 5 daily injections of XXXpenem.  Now I had checked the cost of this kind of drug and I know it's expensive.  But the hospital wanted to charge me $125 USD for each injection.....  That price doesn't tally with what Dr Google tells me 🙂

 

I don't want a diagnosis from the doctor - I've already had that.  I just want a competent medical person to administer the course of XXXpenem injectable antibiotic.

 

Can I buy this medicine over the counter?  If so, perhaps I could then go to Dr Olivier's clinic and have him administer it.

Why don't you just try Bang Lamung or Queen Sirikit? they should be the cheapest 

[Sheryl]

5 hours ago, scubascuba3 said:

Why don't you just try Bang Lamung or Queen Sirikit? they should be the cheapest 

They may not have these drugs....and are even less likely to accept outside lab reports and diagnoses from elsewhere.

 

The main cost is the drug itself. Very new, imported. And probably not on the MOPH list. 

[simon43]

8 hours ago, Sheryl said:

No, you can't buy these IV antibiotics over the counter (and would not save much if you did, the drug costs are very high). But If Dr. Olivier is willing to administer it, he can source it for you.

 

Bill is not likely to be less, though. Might even be more -- but I see no point in sticking with a doctor whom you are not comfortable with and does not have a collegial approach. So maybe have a chat with Dr. Olivier.

 

I don't know what you were looking at on Google, but $125 per dose is about average for these drugs.

 

And you'd need more than 5 day course. 10 at least.

Thanks Sheryl - your comments about the high price are not music to my ears 😞  Unfortunately, the only 2 exclusions on my current medical insurance cover are for BPH and UTIs......

Edited June 13 by simon43

[Lorry]

Not all carbapenems are brand new (imipenem 30 years), and the most common one - meropenem - doesn't have to be imported (Siam has it, for example). They are available at government hospitals. 

 

But you wouldn't get them there.  Yours is a very unusual indication (as you should know by now). 

You can try to find a doctor willing to follow your wishes. 

Or you find a doctor experienced in urological infections who might have other ideas,  still. With a prostate infection you will need weeks of antibiotic treatment, maybe 6 weeks. Carbapenems may not be the right choice. 

2 alternatives spring to mind: combination of antibiotics,  like doxycycline plus moxifloxacin; Japanese antibiotics (not easy to get tested for them in the West and very difficult to find some of them outside Japan)

[simon43]

6 hours ago, Lorry said:

Not all carbapenems are brand new (imipenem 30 years), and the most common one - meropenem - doesn't have to be imported (Siam has it, for example). They are available at government hospitals. 

 

But you wouldn't get them there.  Yours is a very unusual indication (as you should know by now). 

You can try to find a doctor willing to follow your wishes. 

Or you find a doctor experienced in urological infections who might have other ideas,  still. With a prostate infection you will need weeks of antibiotic treatment, maybe 6 weeks. Carbapenems may not be the right choice. 

2 alternatives spring to mind: combination of antibiotics,  like doxycycline plus moxifloxacin; Japanese antibiotics (not easy to get tested for them in the West and very difficult to find some of them outside Japan)

Since the UTI is always present (for years), and since it doesn't generally cause me any serious problems, I'm not keen to fork out $$$ to try to eliminate it (without any guarantee that it won't come back).

 

I note on my culture results that Amoxicillin/Clav is the only oral antibiotic that has some effect (intermediate susceptibility) is noted on the results.  So since this is about 99% (or more) cheaper than the XXXpenem medications, I'll have a go with this.

Edited June 14 by simon43

[Sheryl]

1 hour ago, simon43 said:

Since the UTI is always present (for years), and since it doesn't generally cause me any serious problems, I'm not keen to fork out $$$ to try to eliminate it (without any guarantee that it won't come back).

 

I note on my culture results that Amoxicillin/Clav is the only oral antibiotic that has some effect (intermediate susceptibility) is noted on the results.  So since this is about 99% (or more) cheaper than the XXXpenem medications, I'll have a go with this.

That normally needs a 6 week course, with only intermediate sensitivity might be even more in your case (if it works at all).

 

The issue is not just the sensitivity of the antibiotic against the organism in vitro, it is also how well the antibiotic penetrates the prostate

[Lorry]

41 minutes ago, Sheryl said:

That normally needs a 6 week course, with only intermediate sensitivity might be even more in your case (if it works at all).

 

The issue is not just the sensitivity of the antibiotic against the organism in vitro, it is also how well the antibiotic penetrates the prostate

Correct.

Most probably won't work 

[simon43]

3 hours ago, Lorry said:

Correct.

Most probably won't work 

But no reason not to try it 🙂 .  If it doesn't work then I'm down by about 1,500 baht, as opposed to 25,000 baht!

[Lorry]

1 hour ago, simon43 said:

But no reason not to try it 🙂 .  If it doesn't work then I'm down by about 1,500 baht, as opposed to 25,000 baht!

The reason not to try is that this is not candy. 

It does have side effects,  plus you create even more resistances than you already have,  and you thoroughly destroy your microbiom.

 

If you really want to do this,  I would recommend a culture of semen (or urine after prostate massage) after 2 werks.

[rumak]

On 6/14/2024 at 1:20 AM, Lorry said:

Not all carbapenems are brand new (imipenem 30 years), and the most common one - meropenem - doesn't have to be imported (Siam has it, for example). They are available at government hospitals. 

 

But you wouldn't get them there.  Yours is a very unusual indication (as you should know by now). 

You can try to find a doctor willing to follow your wishes. 

Or you find a doctor experienced in urological infections who might have other ideas,  still. With a prostate infection you will need weeks of antibiotic treatment, maybe 6 weeks. Carbapenems may not be the right choice. 

2 alternatives spring to mind: combination of antibiotics,  like doxycycline plus moxifloxacin; Japanese antibiotics (not easy to get tested for them in the West and very difficult to find some of them outside Japan)

 

your comment that these drugs are not candy is a good one .  all have potential side effects...... with "floxins"  (often given for prostate issues)  being among the black box group .    NOTE: Moxifloxacin is a prescription drug used to treat bacterial infections. It belongs to a class of drugs called fluoroquinolones and can cause serious side effects, such as tendon rupture, peripheral neuropathy...........

[simon43]

On 6/14/2024 at 2:11 PM, Lorry said:

The reason not to try is that this is not candy. 

It does have side effects,  plus you create even more resistances than you already have,  and you thoroughly destroy your microbiom.

 

If you really want to do this,  I would recommend a culture of semen (or urine after prostate massage) after 2 werks.

Lol, haven't seen semen for years - thanks to retrograde ejaculation. But why would I need this when I already have a bacterial sensitivity test results? E.Coli has always been the only bacteria found.

[Lorry]

2 hours ago, simon43 said:

Lol, haven't seen semen for years - thanks to retrograde ejaculation. But why would I need this when I already have a bacterial sensitivity test results? E.Coli has always been the only bacteria found.

To see if there is any result

[Hawaiian]

On 6/15/2024 at 10:07 AM, rumak said:

 

your comment that these drugs are not candy is a good one .  all have potential side effects...... with "floxins"  (often given for prostate issues)  being among the black box group .    NOTE: Moxifloxacin is a prescription drug used to treat bacterial infections. It belongs to a class of drugs called fluoroquinolones and can cause serious side effects, such as tendon rupture, peripheral neuropathy...........

My first experience with fluoroquinolones was Levaquin which was prescribed for a suspected prostate inflamation.   Awful side effects. Tendon in right ankle locked up and the bottom of my feet felt as if they were on fire.  Then, my urologist ordered a prostate biopsy out of caution.  Results were negative. 

I have also used Ciprofloxacin for UTIs.  Similar side effects, but not severe.

When I have taken Cipro in Thailand I have suffered virtually no side effects. 

Twice I have  suffered from urinary retention.  After the second time my PCP doubled my dose of Tamsulosin (Flomax).  Never had that problem again.

Agree, fluoroquinolones are not candy.

[p414]

On 6/13/2024 at 5:58 AM, Sheryl said:

No, you can't buy these IV antibiotics over the counter (and would not save much if you did, the drug costs are very high). But If Dr. Olivier is willing to administer it, he can source it for you.

 

Bill is not likely to be less, though. Might even be more -- but I see no point in sticking with a doctor whom you are not comfortable with and does not have a collegial approach. So maybe have a chat with Dr. Olivier.

 

I don't know what you were looking at on Google, but $125 per dose is about average for these drugs.

 

And you'd need more than 5 day course. 10 at least.

 On 'Line' you will find 'Medisafe'...in Bkk but they deliver free to Pattaya...They will show you the cost of any medicine they have [ also' generic],,

Their medicines are far cheaper than any I found in Pattaya...I pay C.O.D.

[Lacessit]

On 6/12/2024 at 1:19 PM, simon43 said:

Well, my trip this morning to the Urology clinic at Pattaya Memorial hospital didn't go well!  Note that my Thai language fluency is such that I'm able to discuss the medical details etc of my problem in Thai.  But in any case, the doctor whom I saw discussed in both Thai and English.

 

Unfortunately, he seemed to be of the "I am an important doctor and you know nothing" type!  He dismissed my history of BPH, prostate calcium stones (diagnosed at the UK hospital last year), MRI at Burumgrad, 24-needle biopsy, long-term UTI and recent urine antibiotic sensitivity test etc, and declared that I mostly likely had a blockage in my urethra and he was going to prescribe an oral antibiotic (which the culture results clearly showed was unlikely to work - he had a copy of these results in front of him).

 

At my polite insistence that a XXXpenem (XXX means there are several suitable antibiotics of the penem family) antibiotic course of injections seemed to be the best course of action, he said that this would probably clear up the UTI but that it would then return because I hadn't had the urethra obstruction removed...

 

He agreed to a course of 5 daily injections of XXXpenem.  Now I had checked the cost of this kind of drug and I know it's expensive.  But the hospital wanted to charge me $125 USD for each injection.....  That price doesn't tally with what Dr Google tells me 🙂

 

I don't want a diagnosis from the doctor - I've already had that.  I just want a competent medical person to administer the course of XXXpenem injectable antibiotic.

 

Can I buy this medicine over the counter?  If so, perhaps I could then go to Dr Olivier's clinic and have him administer it.

If I encountered a doctor who won't listen to me, I would change them.

 

It's only happened once, with a doctor who should retire.

[KannikaP]

On 6/8/2024 at 1:44 AM, Lancelot01 said:

My health improved and, more importantly, my medical insurance premiums dropped almost 50%.

But you were not covered for you pre-existing conditions, no?

[Lorry]

On 6/6/2024 at 1:49 PM, simon43 said:

This is a follow-up to my previous posts about my prostate problems. I'm posting again because I'm back in Thailand after 18 months in Laos, and therefore have easier access to blood tests, competent doctors, medicines etc.

 

Here's a brief history of the problem:

I have mild BPH for many years, but can function fine with a daily pill of Alfuzosin.  Because of the BPH, my PSA is raised somewhat, typically about 6.0, but steady

 

About 2 years ago, when living on Phangan Island, a PSA test showed that my PSA had increased to about 15.  So I went and had an MRI prostate scan at Bumrungrad which showed 2 shadow lumps within my prostate.  The hospital suggested a biopsy to investigate further, but due to some insurance problems I was forced to return to the UK for further treatment.

 

A biopsy was performed (24 samples), and none were positive for cancer.  The doctor suggested that the lumps were beign calcium stones.  Importantly, myPSA value was raised above my normal 6.0 due to long-term UTIs.  The doctor in the UK had delayed my biopsy for almost 2 months while he tried different antibiotics to eliminate the infection, but he was unable to achieve this!  The UTI remained.... So he went ahead with the biopsy and the results were all good.  I returned to Laos and the UTI has remained ever since.

 

Now I'm back in Thailand, I just had a blood/urine test.  All looks good with (of course) the exception of my UTI, with a high level of white blood cells in my urine.

 

I do not think it is a good idea just to let these prostate infections continue.  I'm wondering if I should follow a path of further investigation to identify exactly what bacteria is present in my urine.  I recall that my UK doctor said that it was the common E.Coli.

 

To confirm this, is there a urine bacterial test that can be done?  My blood/urine test was performed today by Life Sciences (Pattaya), whom I have used for many years.  Perhaps I'll go back with my urine results and ask if they can identify in detail what bacteria is present.

 

I followed the advice of posters (Xylophone and others), who previously suggested specific antibiotics to take.  Alas, none of them cleared up my long-term UTI 🙂

 

The UTI does not cause me too many problems, but I simply feel that it's not healthy for me to have this UTI on a continual basis.

 

So, any suggestions as to a step-by-step process to eliminate this UTI once and for all?  Thanks.

How successful have you been?

Dis Amoxiclav work?

Where you able to get carbapenems?

[simon43]

22 hours ago, KannikaP said:

But you were not covered for you pre-existing conditions, no?

Of course not! My medical insurance covers everything (including prostate cancer), but not my pre-existing condition (BPH and UTIs).  That is absolutely to be expected.

 

@Lorry, I gave up trying to obtain carbapenems because of the cost, and also because my UTI is symptomatic, ie - it's always present but causes me few problems, usually no stinging when I pee etc. But lab tests always show the presence of this E.Coli.  I just live with it 🙂

[JimHuaHin]

On 6/16/2024 at 3:07 AM, rumak said:

 

your comment that these drugs are not candy is a good one .  all have potential side effects...... with "floxins"  (often given for prostate issues)  being among the black box group .    NOTE: Moxifloxacin is a prescription drug used to treat bacterial infections. It belongs to a class of drugs called fluoroquinolones and can cause serious side effects, such as tendon rupture, peripheral neuropathy...........

I cannot but agree with rumak.

 

About 6 years ago I had an inflamed prostrate impacting urine flow.

 

My then gf (a Thai nurse with 25 years experience) took me (in pain) to the local hospital.  The doctor gave me a 5/7 days course of ciprofloxacin tablets.  I asked her if the medication was safe, she replied "yes, good song medicine"  (my first mistake!!).  The medication had little impact on my symptoms, so I was admitted to hospital for a five day course of IV ciprofloxacin.   All good.  About 3 years later, the same problem returned.  Now separated from nurse gf, I took myself back to hospital, was admitted to the ER, and given the same medication.  This time, I was better after 3-4 days, and then I did what I usually do with new medications, went to MIMS website and checked the medication.

 

The US FDA issued an urgent warning about ciprofloxacin about 5 years ago, warning of potential permanently disabling side-effects and that the medication was contraindicated for those over 65 (I am 68 now).  A few months later I started having problems with both my knees.  Luckily the problems disappeared after a few weeks, but periodically return for a few days.

 

[rumak]

you are lucky .  there are lawsuits by the injured  https://www.drugwatch.com/cipro-levaquin-avelox/lawsuits/

[Ben Zioner]

23 minutes ago, JimHuaHin said:

The doctor gave me a 5/7 days course of ciprofloxacin tablets. 

Wat too short for a prostatitis. Minimum being 30 days.

[orang37]

Man, that sounds really tough. I’ve had issues with recurring UTIs myself and had to go through a lot to get them sorted. Definitely get a urine culture done if you haven’t already; it’ll pinpoint the bacteria and help figure out the right antibiotics.

I ended up seeing a specialist who really knew their stuff about chronic infections, and that made a huge difference for me. Maybe a urologist could offer some fresh insights or treatments for your situation.

[JimHuaHin]

23 hours ago, rumak said:

you are lucky .  there are lawsuits by the injured  https://www.drugwatch.com/cipro-levaquin-avelox/lawsuits/

Agreed on the luck.

 

I doubt lawsuits initiated by farangs would work in Thailand.

[Lorry]

9 hours ago, orang37 said:

 

I ended up seeing a specialist who really knew their stuff about chronic infections, and that made a huge difference for me.

Was that specialist in Thailand? 

If yes, who?

[p414]

On 6/14/2024 at 6:57 AM, simon43 said:

But no reason not to try it 🙂 .  If it doesn't work then I'm down by about 1,500 baht, as opposed to 25,000 baht!

Posted before but 'LINE' 'medisafe' in BKK..

They sell medicines etc online .you will be shown the cost before purchase and can refuse ...

They deliver free to Pattaya and you can pay C.O.D.....

[p414]

I have seen that Bangkok Hospita; Pattaya now have 'Rezum' treatment for prostate shrinking...

This is a one-2 hour treatment and no stay in the hospital..

Has anyone here had this and will it mean I no longer need to take the Dutasteride and Tamsulosin medicine I am now taking [2+years]./

 

Thanks, in advance, for any response

[Sheryl]

18 hours ago, p414 said:

I have seen that Bangkok Hospita; Pattaya now have 'Rezum' treatment for prostate shrinking...

This is a one-2 hour treatment and no stay in the hospital..

Has anyone here had this and will it mean I no longer need to take the Dutasteride and Tamsulosin medicine I am now taking [2+years]./

 

Thanks, in advance, for any response

There have been several prior threads specifically about Rezum. This thread here is about prostatitis.

 

Google "Rezum site:aseannow.com"

[p414]

37 minutes ago, Sheryl said:

There have been several prior threads specifically about Rezum. This thread here is about prostatitis.

 

Google "Rezum site:aseannow.com"

Thanks Sheryl..