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Having chills. Urine culture showed E coli. Took Amikacin and Norflox. How to treat chills?

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I am having chills since 45 days. Urine culture shows e coli, sensitive Amikacin & Norflox. Even after the course, I still have chills.I am 60 yrs, male,
Posted Sun, 15 Dec 2013 in Infections
Answered by Dr. Rakesh Karanwal 43 minutes later
Brief Answer: 10-14 days' treatment is ideal for UTI. Detailed Answer: Hi XXXXX, Thanks for your query. Firstly, I presume that you had taken both drugs together : Norflox + Amikacin. However, the duration of treatment for UTI scientifically is 10-14 days. The aim of treatment is to COMPLETELY eradicate E.coli bacteria. Even a single surviving bacteria propagates rapidly to cause re-infection. Hence, please continue the treatment, without break, for at least 10 days. Further, BEFORE stopping treatment, get urine examination repeated- which, if normal- may be taken as an indication for stopping treatment. Secondly, in the presence of kidney/bladder stones, or kidney/ bladder structural abnormalities which promote retention/stagnation of urine, a longer course (2 weeks or even more) of treatment is mandatory. If the post-treatment urine report is still abnormal, an ultrasound of the urinary system becomes mandatory. Other cause of delayed response is presence of underlying and undiagnosed diabetes or a concurrent fungal infection. Hence, Blood sugar should also be done to rule out/confirm early/hidden diabetes. Presence of fungi in urine will confirm the diagnosis. In case, fungus is isolated, a 7-10 days' course of oral anti-fungal drug is indicated. Lastly, and MOST IMPORTANT, persistence of chilly sensation alone, is NOT an indication of ongoing UTI. On the contrary, disappearance of clinical symptoms, such as fever, increased frequency of urination, burning sensation while passing urine, pain in flanks/lower abdomen, indicates NEAR-TOTAL/TOAL eradication of urinary infection. TOTAL eradication of infection can be confirmed ONLY by urine analysis and particularly urine culture. If you live in an area which is endemic for malaria and continue to have chills, please get yourself tested for underlying and undiagnosed malarial infection. Consult your doctor and apprise him of my opinion. I am certain that he agrees with my opinion and clinical acumen; order required tests, and- based on the reports- will arrive at a certain diagnosis and prescribe suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and Take Care, Dr. Rakesh Karanwal
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Follow-up: Having chills. Urine culture showed E coli. Took Amikacin and Norflox. How to treat chills? 16 hours later
Thank you for your answer. I had taken Amikacin intravenous for five days and Norflox for seven days. That time, my doctor did not give me Cital. The urine culture done after the treatment still showes e coli. Now my doctor has advised Levoflox 500 once daily and Niftran 100 thrice daily and Cital thrice daily. I am anxious about the anitibiotics. So I have just taken Cital since yesterday and today I do not have any chills till this afternoon. Also, my doctor has asked me to get the culture done from another lab.
Answered by Dr. Rakesh Karanwal 16 minutes later
Brief Answer: Take medicines as advised by me Detailed Answer: Hi XXXXX, Nice hearing back from you. So, my diagnosis was CORRECT! I WILL STRONGLY RECOMMEND THE FOLLOWING :- * CONTINUE with Amikacin for 10-14 days, without break! * Take NIFTRAN for a MINIMUM of 10 days- nothing short of that! Inadequate course is THE cause of recurrent UIT and development of drug-resistance. * CONTINUE with NORFLOX for another 7 days. * Cital is not required. --> Get your urinalysis and urine culture done ONLY AFTER COMPLETION OF THE ENTIRE COURSE OF ANTIBIOTICS AS ADVISED. Please follow my advice if you wish to be cured completely. You may revert back to me with the urine culture report- done after completion of antibiotics' course. Take care Dr. Rakesh Karanwal
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Follow-up: Having chills. Urine culture showed E coli. Took Amikacin and Norflox. How to treat chills? 2 days later
My new urine culture test shows no organisms. Still chills are there. Should I test for Dengue?
Answered by Dr. Rakesh Karanwal 6 hours later
Brief Answer: Malarial Antibodies test is more important Detailed Answer: Hi XXXXX, Firstly, Dengue does not last for such a long time. So, it would a waste of time and money. I would ONCE AGAIN recommend that you get TESTED FOR MALARIAL ANTIBODIES (IgG & IgM), which is much higher on the chart of possibilities. Please do NOT stop the treatment for UTI and do make it a point to complete the treatment as advised. Lastly, as I said before, mere occurence of chills do NOT indicate an ongoing infection, EXCEPT for malaria. Hope you get the malarial test done. Take care, Dr. Rakesh Karanwal
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