Conversation: The conversation between human and AI assistant.
[|Human|] Hi I recently went to Urgent Care and was treated for a UTI.  I have 2 days left on my antibiotic and I still have symptoms and they seem to have gotten worse.  I now have this pain in my lower abdomen when I sit down or stand up.  This just started maybe a day ago or so.  The pain is very uncomfortable and Im not sure what is going on.  I get chronic UTIs so the fact that the antibiotic isnt working and I have this lower abdominal pain concerns me.  I do not have insurance and I know that the ER will just tell me to go to a OBGYN which is what they told me before.  Any insight?
[|AI|]  Hi, thanks for asking in Chat Doctor. Most often, UTI is caused by gram negative organisms. Acute infections usually involve a single organism and are self limiting. Recurrent or chronic infections may be mixed infections. It could be due to many reasons like bacterial infections, Diabetes Mellitus renal calculi (stones) etc. Since you seem to be getting repeated infections, cause of UTI needs to be investigated instead of taking antibiotics every time. Bacteriological investigations are important in deciding the choice of the antibiotic. Although we don't usually wait till the arrival of report for starting the antibiotic, urine sample must be collected before starting the therapy for better results.  Most antibiotics attain high concentrations in urine and so may be effective in lower UTI. But in upper UTI (like pyelonephritis), the antibiotics needs to be concentrated in kidney tissue. Antibiotics are given for 3 to 5 days. In recurrent UTI, the choice of antibiotics are Clotrimazole, Cephalexin or Norfloxacin. The pain you are experiencing may be due to cystitis (bladder infection), pyelonephritis (kidney infection) or renal calculi (stones causing obstruction and subsequent infection). Ruling out these possibilities is necessary to decide further course of therapy. Inadequate therapy or indiscriminate use of antibiotics is often harmful as it can result in development of resistance.  The organism or bacteria will not be sensitive to the antibiotic if it becomes resistant to it. Hence, you should complete a full course of antibiotic.  I hope it is useful to you.