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.