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Suffering from fever. Treated for malaria and typhoid. Have chest infection. Safe to start AKT3?

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Practicing since : 2003
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My brother is suffering from fever since a month. he has already been treated for malaria and typhoid. however, there is a chest infection. Our regular doctor is out of station. We consulted 2 doctors.One prescribed Augmentin 625 mg for 5 days. The second wanted us to immediately start on AKT 3. The test for TB will be done shortly and the results will be available in 48 hours. What should we do now? Fever has gone up to 102.ESR level is 80 now. Is it alright to start AKT 3 without confirming TB? Will there be side effects?
Posted Sun, 7 Oct 2012 in Infections
Answered by Dr. Gyanshankar Mishra 1 hour later
Thanks for posting the query on XXXXXXX
After going through the query, I would like to comment the following:

1. Your brother seems to be suffering from chest infection and fever since one month.

2. In such a case the chest infection needs to be investigated. Sputum examination for afb stain and culture, Gram stain and culture, chest xray pa view and if required HRCT scan thorax.Also the lymph nodes need to be examined. If a chest physician is available then a bronchoscopy may be done.

3. Mantoux test normally read after 48 hours is an indication of TB infection and not necessarily TB disease.

4. Normally in absence of investigations in a case of chest infection a 2 week course of antibiotic like augmentin 625 twice a day is prescribed and if there is no response then anti tb drug can be prescribed as per body weight and it should be AKT4 and not AKT 3 .

5. Sometimes side effects of Anti TB drugs do occur but they are manageable.

I hope I have answered your query. I will be glad to answer follow up queries if any.

Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Consultant Pulmonologist
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