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URINARY INFECTION symptoms persists on ANTIBIOTICS. Should see doctor?

Resolved Question:

If you have an upper urinary tract infection and are currently on antibiotics, should you return to the doctor or hospital if symptoms persist or worsen?

Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at
It depends on how many days has elapsed, since the antibiotic was started and also what antibiotic is it.
UTIs can take up to 2 weeks to heal and all the measures including drinking at least 4 liters of water, more of cranberry juice and the antibiotic needs to be taken strictly.
But if you do have persistent lower abdomen pain, or there is any blood in the urine, it is better to go to the hospital and get a repeat urine test done.

Patient replied :

App-Sulfatrim Ds 88/160 mg is the antibiotic they gave me. I have had the main for almost two weeks now and the symptoms are not getting better they are persistent and worsening

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Thank you for the follow up.
Can you elaborate on your symptoms? And was an urine culture done? If so, what was the organism?
Since it has not resolved in almost 2 weeks, i will advise you to get a repeat culture to find out what organism is growing.
Otherwise you can start Tab. Nitrofurantoin 100 mg thrice daily after food for 7 days, it is extremely effctive in UTIS.
Along with that you can take Tab. Urispas twice daily if there is pain while passing urine.
Drink plenty of water and also consume cranberry juice as i mentioned.

Patient replied :

They did a urine test at the hospital and found a high count of white blood cells which is why they prescribed the current medication/antibiotics. Also. Symptoms I'm in excruciating pain no matter the pain killer I take usually in my side, back and abdomen. I also have severe nausea and vomiting.

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

High count of white blood cells only indicate an active infection.
They should have done urine culture, which is a more specific test and also helps to determine what organism is growing in the urine and what is it sensitive too.
So i will request you to get a culture done.
Regarding the abdominal pain, it mostly is due to uncontrolled UTI, but if it is worsening, then an Ultrasound Abdomen should be done, to rule out kidney stones. Even presence of kidney stones can make you prone to develop UTIs. It is one of the possibilities, so please do not panic.
Kindly get the tests done as soon as possible and based on that appropriate management can be planned.

Patient replied :

I went to family doctor on Thursday ti check it out and the pain similarly changed spots towards my lower right side and abdomen. He thought it was appendicitis but the emergency room said all my tests came back clear now an that I just had a virus they could do nothing but pray for me. I don't know if I should go to another doctor bc I don't understand how after day the tests can be negative then positive and not have any solution to the problem

Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Thank you for the follow up.
There are a few things I would like to know about your symtoms; In addition to the pain in your lower right abdomen and back, do you experience pain while you urinate? Have you seen any blood in your urine? Have you measured your temperature or noted feeling warm to touch?
A urinary tract infection should normally respond to the antibiotics provided you completed the course entirely. If the pain orginates from your urinary system, the continued presence of pain indicates that the infection has either not resolved or that you are having kidney stones. For us to help you better kindly attach the reports of the abdominal ultrasound and the urine culture. The high white count only tells us that you have an infection but not where the infection is. These reports will help us guide you better.
Should the pain continue or change nature suddenly, it is my recommendation that you kindly see internal medicine specialist in a hospital where you can be examined more thoroughly.

Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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