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She already has a urogynochologist so why are you asking us non physicians? Does she have diabetes? A permanent cath requires daily anticeptic practices als also can contribute to infections.Why go to the PCP to get antibotics? The urologist should already doing best practices? You can also ask for a second consult with a urologist.
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I've been told that just getting the urine more acidic will help. Therefore, eating oranges or any fruit high in vitamin C or taking vitamin C tablets will help. I augment my mother's meals with any high water fruit, e.g. watermelon, grapes, etc. My mother will not drink cranberry juice, however she will drink orange juice, mango juice, etc. She doesn't like the taste of water or coffee. However, she will drink tea. I try to pump her full of fluids.

She resists taking in all this fluid because it makes her go to the bathroom more often. For me, the Vitamin C tablet has worked the best.
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Cranberry juice is not good because of the sugar. My Mom was on cranberry tablets and a probiotic daily for a year before she passed and had no UTIs in that year,

My daughter says doctors start out with a broad spectrum antibiotic. What you to make sure is done is that a culture is taken to see what bacteria they are dealing with so the correct antibiotic is given. If she leans foward, that helps to void. Sitting a little longer may give her the urge to go again. My Moms doctor asked that she get a sling to out her bladder back in place. She refused. A catheter maybe her best bet but as Alva says, they can also cause UTIs.
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Summernole, I don't suggest cranberry. Most is full of sugar and that's a no no for someone already having infection. Trader Joe has some without sugar but it isn't well tolerated. It's acidity is way too much for most elders. There are many things that do the same thing cranberry does and I am surprised, as she has a urologist, he hasn't suggested some to you. I would check on that. Glad that the cultures are being done. Sounds like you are doing all you can. Bladders for the elderly go all neurogenic and result is often frequent infections, sadly.
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LoopyLoo Oct 2023
Alva is absolutely right. When my grandmother had recurrent UTIs, I told her not to buy Ocean Spray or any cranberry juice. She did anyway and couldn’t understand why it didn’t kill the UTI.

Sugar also feeds yeast, and I don’t have to tell you how that ends up. Yikes!
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My aunt is bedridden and on Hospice care at home. She just got her catheter last week. What a blessing because she is heavy and it was very difficult to move and keep her dry & clean.
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The low dose Cipro might help. I don’t think either the cranberry or D-mannose does anything except keep the nutraceutical companies in business. I was taking both and had more utis than I did after I stopped taking them. Go figure.

My mother gets them too. She’s had at least three this past year. She responds well to Cipro.
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Take her to see a gyno-urologist.
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Summernole Oct 2023
She has a urogynacologist.
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They COMMONLY used to put such elders on a daily prophylactic dose of Cipro. Now you are lucky to get Cipro at ALL as some side effects that were exceptionally rare put it out of favor. Sadly this is seldom done anymore, and more sadly, this inability to empty the bladder makes these infections more frequent.

I had frequent bladder infections that often moved to my kidney, and was under threat of daily doses a bit more than a decade ago. It was recommended I try D-Mannose, one capsule daily. I had no faith in this as, as an RN, I don't really believe in supplements and vitamins without a very good reason. I tried it and I haven't had a single UTI in over a decade. Works much like cranberry but not acidic. Keeps bacteria from adhering to the bladder wall. Easy to take and if capsule too large to swallow break open and put in food. Very slight sweet to tasteless. Worth a try. Has worked for others I have recommended it to I would say 80% of the time. I use Source Natural, about 30.00 for 120 capsules on Amazon, but I suspect they are all much the same.
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Summernole Oct 2023
She has been taking D-Mannose for about 5 months. I does not seem to help at all. Of course, with her hospitalizations and now rehab she is no longer getting it. I just don't believe in it. She was taking 2000 mg daily. Thank you but I don't think it has helped.
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Dear OP, some suggestions:
1) Watch really carefully to see how she is wiping her bottom after a bowel motion. If she wipes from back to front at any stage, she is transferring the (I think it’s) ecoli from the feces forward to where the bladder empties just by the vagina. She should be reaching behind her, not backwards between her legs. That will cause a fresh UTI. She might have started to do this because it’s actually an easier movement, but it’s a seriously bad move.
2) This could be one where drinking cranberry juice regularly could help. It’s not strong enough to cure anything, but it probably makes the bladder a bit more resistant.
3) Are you sure that her UTIs are being cultured and tested fully? I had one that didn’t clear up in spite of the antibiotic that the doctor prescribed immediately. When the full test came back from the lab, it was a different unusual infection, and cleared up with a different antibiotic.
4) To help her empty her bladder completely, she should sit on the toilet seat with her knees apart, lean forward to compress her stomach, and push.

I hope this helps a little bit. Yours with sympathy to both!
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Summernole Oct 2023
Thank you, Margaret. My mom does not let me in the bathroom with her so I can't see how she is wiping. She does have baby washclothes that she is to use to clean herself. No soap or lotions. She knows that. We haven't been using the cranberry juice because we keep reading that it is not confirmed to help with UTIs but it might be worth a try. Her UTIs are being cultured to determine the antibiotic and I have to trust her PCP. I think she knows to lean forward but she is 92 and has probably forgotten. Thank you for your information. If she comes home I will make sure she drinks cranberry every day. Even if it is not confirmed to help we will give it a try.
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