Pharmacists, is it okay to take Cipro and Amoxil simutaneously?

Following lithotripsy with a ureteral stent, my husband developed burning urination, fever, chills, loss of appetite, nausea and lithargy which landed him in the emergency room where they tested his urine, found increased WBCs and administered IV antibiotic and sent him home with a Rx of 500mg Cipro/ 2xdaily. Blood analysis results are pending. His 2nd lithotripsy was cancelled for today and he instead had a renal/bladder ultrasound and KUB xray (results pending). His urologist's nurse called to take him off Cipro and start him on Amoxicillin 250 mg 3xdaily, which he has not started yet. I know Cipro is the gold standard for UTI's and am puzzeled as to why they switched to Amoxicillin, especially since the burning with urination has completely resolved. The nurse said, "yes, the Cipro would clear up the UTI." I'm pretty upset because they brushed off the UTI two weeks ago when my husband complained about burning, and said it was usual side affects of the stent. (more below)

I just don't understand why his doctor would say on one hand the Cipro got rid of the burning but then on the other hand say he needs to switch to Amoxil to "fight the bacteria they are going after," especially since they dont have the blood results back yet. My husband is hesitant to switch, since he is finally beginning to feel better. I agree. So..his choices are: 1) continue taking the Cipro and ignore his doctor's orders (at least pending the blood results)
2) switch to amoxil and hope the burning doesn't return, or
3) take both the Cipro AND Amoxil (but is this safe?)

I'd like to hear from qualified people who have degrees in pharmacology

Thanks.

I don't have a degree in pharmacology, but I am a Medical Laboratory Technician and work in microbiology.

The doctors can't tell anything about the specifics of the urinary infection from bloodwork. Most likely, the doctor has ordered a urine culture and gotten (at least) preliminary results back. If you don't know, a urine culture involves putting a small amount of urine on petri dishes full of nutritional media and actually growing a sample of the infecting bacteria, and then exposing the bacteria to several different antibiotics to determine which one would be most effective. Physicians can have a preliminary report back within 8 to 12 hours.

Cipro is prescribed for UTI's because those infections are usually caused by gram-negative bacteria -- the kind that naturally live in your digestive tract. Human feces are full of this kind of bacteria, and UTI's often occur because of cross-contamination between the anus and urethra. Its a good bacteria to start someone on when they present symptoms, because its effective against the "usual suspects".

But practically any pathogenic bacteria can cause a UTI. The urine culture report probably showed the presence of a different kind of bacteria that could be more effectively treated with Amoxicillin. This particular change of drugs leads me to think that his UTI might be caused by a staph infection. This wouldn't surprise me because of the procedures that you've described.

My advice would be to follow the instructions of the doctor. He doesn't need to take both at the same time. Because Cipro targets the kind of bacteria that naturally live in your digestive tract, taking an antibiotic that kills them might cause him some gastrointestinal problems.

If you have further concerns, you should make an appointment with your husband's urologist and ask him to discuss the *culture and sensitivity* results with you.