MS patient w/seizure disorder. Can only take Avelox as antibiotic. Rx does not seem to be working.?

Question

All other antibiotics tried cause seizures. Has supra-pubic catheter to stop UTI's, but has not worked. Need to find Rx that cures UTI but does not cause seizure. Patient cannot speak or walk. Did have heart attack in 2005. Age 27. MS diagnosed 2004.

Answer 1

where there is a cathetar there will always be infection. Suggest that a urologist be consulted as well as an allergist.

Answer 2

There are a lot of antibiotics and there may be some that you are unaware of and have not been tried. I regard moxifloxacin (Avelox) which is a fluoroquinolone as an excellent antibiotic in general and for urinary tract infections in particular but all fluoroquinolones may lead to seizures. Seizure risk with oral antibiotics is dependent upon whether or not the drug has a significant penetration into the central nervous system and whether or not the antibiotic interferes with the metabolism of the seizure medications. You did not say what type of seizure nor did you say if this person is on seizure medications. I am sorry that such a young person has such advanced and refractory MS. If you provide additional information I will offer more specific advice [e-mail]

Answer 3

It would help if you could tell us the infective organism and the antibiotics that this young gentleman is allergic to. Also what part of the urinary tract is infected. (bladder, ureters, urethra etc.).I would have to guess that it is a gram-negative bacillus or enterococcus.
Avelon is the trade name of moxifloxacin, a member of the fluoroquinolone group of antibiotics (all relatives of nalidixic acid).
Athough they work well, all or almost all ot them, are neutralised by one point mutation, by mutated resistant bacteria. Other treatments for recurrent urinary tract infections (and an indwelling catheter is an invitation to invasive bacteria.), are nitrofurantoin (100mg , oral, (po), daily, q24h for 6 months.
Alternatives are amoxicillin 500 mg oral, (po) q24 for 6 months, or trimethoprim plus sulfamethoxazole one ss tablet every 24 hours (q24) for 6 months. Yes I suspect that he is allergec to the last two. But I mention them on the off chance that they may have been overlooked. All the oral doses can be usually be converted to subcutaneous or intravenous form by a competent pharamologist or by telephoning the manufaturer. (or checking Physicians' desk reference, (P.D.R.), or the Canadian equivalent, C. P. S.).
There is a long list of other potentail members of families of other antibiotic that can be used. For example penicillins, cephalosporins, amino glycosides, tetracyclines
if the infective organism is a yeast, (unlikely), then all the above suggestions go out the window. Fungi do not respond to most antibacterial antibiotics, and there are specific antifungal drugs that kill them. I presume that his physician has had tests to determene the causative organism, and also antibiotic susceptibility tests done for that organism. If it is an Escerichia coli, (E. coli), infection, then cranberry juice, used with other antibiotics, will help. It was long suspected to aid U.T.I.'s but has just been reported by a research laboratory to do so. (it interferes with the bacterium's ability to latch onto urinary tract & vaginal cell's outer membrane proteins.)
If none of these antibiotics are suitable, there is a new, experimental antibiotic, (reported in the scientific press), (Nature, Vol. 441, p358) that has been isolated in a South African soil bacterium, Streptomyces platensis, called platensimycin. This antibiotic is novel and it kills bacteria by a totally new mechanism. Namely, by preventing fatty acid synthesis. It readily kills methicillin (MRSA), and vancomycin, (VRSA), resistant (multidrug), Staphylococcus aureus bacteria. I will have to Google for the laboratory that is working on the pharmaceutical. You should be able to get it on compassionate release grounds if that becomes your only option.
There is an outside chance that an abcess or kidney stone may be the cause of reinfection. Both scenarios are highly unlikely but worth mentioning, nonetheless.
Another long shot that I have very occasionally resorted to are , trained Chinese traditional medical personnel, (one is a graduate of the University of Beijing),, and also Ayurvedic doctors. (Hindu medical personnel, ). They have, on rare occasions, come through when no other Western medicins nor treatments worked. (that makes me an eccentric but what the hay).
Add this information to the previous two excellent, answers above , and you have considerable information to bring to the attendant physicians.
Good luck, and God bless.
Doc. Dan.