Your symptoms of burning urination, urgency, and lower abdominal pain along with "pus cells but no growth" point toward sterile pyuria or urethritis rather than a typical bacterial bladder infection.
When a standard 48-hour culture shows no growth despite persistent lower urinary tract symptoms, common culprits include fastidious organisms (like Ureaplasma or Chlamydia), chemical irritation, or pelvic floor muscle spasm.
Furthermore, your inability to swallow tablets explains why previous therapies failed, as extended-release tablets cannot be crushed without destroying their mechanism.
Next Steps
Increase your fluid intake immediately with 2.5 to 3 liters of water daily, and consider a urine alkalinizer syrup (like disodium hydrogen citrate) to quickly relieve burning sensations.
Please book an online consultation with me so we can evaluate non-tablet antibiotic options and test specifically for organisms that do not grow on routine cultures.
Health Tips
Never chew, crush, or break extended-release (ER/XR) tablets, as doing so delivers the entire dose at once, which causes severe gastric irritation and drug toxicity.
Avoid bladder irritants such as coffee, strong tea, carbonated drinks, citrus juices, and spicy foods until your urinary tract fully recovers.
Seek immediate physical emergency care if you experience a high fever with chills, severe one-sided lower back (flank) pain, or blood in your urine.