Download FREE Practo app
Get ₹200 HealthCash
Query for UTI
My father was admit in hospital for head injury but now he got UTI i.e. nitrite positive in urine culture, he is on treatment inj Ceftriaxine, nitrofurantoin tablet, PCM tablet, but fever spikes are more in night, 48hrs has happened since this treatment, still there are spikes, l want opinion on this? Is there more additional treatment has to give or investigation has to be done? Am l missing something ?
Answers (29)
Get your queries answered instantly with Care AI FREE
20000+ health queries resolved in last month
Continue your doctors treatment.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+117
urine culture and sensitivity to be done.Based on that report we can choose alternative antibiotic
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
If you want to discuss your problems, pls text me on whatsapp on seven two seven eight nine two seven six three eight, i will guide you step by step.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Add norflox 400mg tab.od
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
You can consult me directly on Practo, or reach out via WhatsApp:
Eight Seven Six Two Seven Four Nine Nine Seven Four
I’ll guide you step-by-step with easy-to-follow treatment plans.
Early consultation helps avoid complications — feel free to connect.
Only whatsapp message no calls
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Need to know if there are any other comorbidities and other history. For further evaluation and management kindly consult me on practo
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Hello,
I am Dr. Romain Rajan, General Physician (Ex Govt Medical Officer at RML Hospital, New Delhi), and your case has been allotted to me.
Thank you for explaining the situation clearly. Your concern is valid, and Iâll address it step by step.
Understanding the current situation
Your father developed a UTI during hospital admission (very common after head injury, catheterisation, immobility).
A nitrite-positive urine suggests a bacterial UTI, usually gram-negative organisms.
He is currently on:
⢠Inj Ceftriaxone
⢠Nitrofurantoin
⢠Paracetamol
After 48 hours, it is not uncommon for fever spikes to still occur, especially at night, but this does warrant close review.
Possible reasons for persistent fever spikes
⢠Infection not yet fully controlled (48â72 hours is the usual window to see response)
⢠Organism resistant to current antibiotics
⢠Upper UTI or pyelonephritis
⢠Catheter-associated infection
⢠Another source of infection (lungs, blood, pressure sores)
⢠Post head-injury fever or central fever (important to consider)
What should be reviewed or investigated now
You are not missing anything, but at this stage doctors should consider:
⢠Urine culture and sensitivity report
â Most important to confirm if antibiotics are appropriate
⢠Blood tests
⢠CBC
⢠CRP or Procalcitonin
⢠Renal function tests
⢠Blood cultures if fever is high or persistent
⢠Chest evaluation if cough or low oxygen is present
⢠Review catheter
⢠Remove or change catheter if present
About treatment escalation
At this point:
⢠Do NOT change antibiotics blindly
⢠If fever persists beyond 72 hours or worsens, antibiotics may need upgradation based on culture
⢠Paracetamol will control fever but will not treat the cause
Red flags that need urgent escalation
⢠Fever >102°F repeatedly
⢠Drop in BP or urine output
⢠Altered sensorium
⢠Rising creatinine
⢠Signs of sepsis
Important reassurance
Persistent fever at 48 hours does not mean treatment has failed, but it does mean reassessment is needed, especially culture-based decision making.
You are asking the right questions at the right time.
If you want, you can share:
⢠Age of your father
⢠Whether catheter is present
⢠Culture report (if available)
⢠Latest vitals
For a one to one discussion and guidance on investigations or antibiotic strategy, you can reach out to me on WhatsApp at 85271646 seven seven.
Wishing your father a smooth recovery.
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Correct Antibiotics given after the culture report, usually takes around 2 days to show the results.If the fever lasts beyond 2-3 days,it could be catheter induced infection or other associated conditions.His doctor may repeat the necessary blood tests
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
You can add fosfomycin packet once for 3 days. even if symptoms persists then urine culture and sensitivity should be done.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Need more info in urine culture
Check for which antibiotic sensitive and resistant
If catheterized, change the catheter
If still persist look for Dengue, Malaria and widal and CRP, WBC count
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
In elderly patients, fever due to UTI may take 48–72 hours to settle even after starting antibiotics, so persistent fever at 48 hours does not always mean treatment failure; however, it is important to review urine culture and sensitivity, ensure the antibiotic matches the organism, and check for factors that delay recovery such as diabetes, urinary catheter, prostate enlargement, urinary retention, kidney involvement, or another infection source. Additional tests like CBC, CRP, kidney function tests, blood culture (if fever persists), ultrasound KUB, and HbA1c (as diabetes worsens UTI) may be needed, and antibiotics should be adjusted based on reports rather than adding medicines blindly. Close monitoring by the treating team is advised, and if fever continues beyond 72 hours or condition worsens, further evaluation is necessary.
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Whether catether is on
Than infection increase so fe er is high.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Some more information is required.....
Whether he is catheterized or not....
If he is catheterized then which cather is used...
If he is on simple foley's cather then it should be changed every in 15days.
If he is able to pass urine himself then cather can be removed(which can be a source of infection)
If his consciousness is altered but he is able to pass urine himself then malecath can be used.
Antibiotic according to urine culture should be given.
Repeat CBC and Urine culture is advisable.
Oher source of fever must be ruled out.
Answered
Flag this answer
2/2 people found this helpful
Was this answer helpful?
YES
NO
Please get the CBC and tests for Dengue and Malaria also done and consult with your Doctor who is treating your father.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Just wait
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
You can ask the team looking after your father about the following,
1. Blood cultures
2. Screened for infections elsewhere like chest, abdomen, joints and CNS site etc
3. Any concerns re multi-resistant bacteria
All the best.
J G S R Clinic
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Get lab reports done again then we can evaluate further. Do contact with latest report for further treatment plan.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Ongoing Treatment is good , please do once more urine culture and cbc done.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Get urine culture and since he is in hospital get urologist opinion
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few details please consult for further evaluation and treatment
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Shaikh Huzaif
General Physician
20 yrs exp
Mumbai
Please consult
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Shahbaz Khan
General Physician
4 yrs exp
Delhi
It will take some time but you will see the fever gap increasing with decreased levels of fever that will mean the medication is working
Check the temperature charts
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Sumit Verma
General Physician
4 yrs exp
Kanpur
Where is your cultur sensitive report.
Choose antibiotics after this report.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Drink plenty of water
Avoid oily and junk foods
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Hba1c needed
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Gaurij Hood
General Physician
18 yrs exp
Valsad
Continue medications for atleast one week.Pls connect for further discussion and solution.
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Sajid Ali
General Practitioner
4 yrs exp
Kanpur
Urine culture
Answered
Flag this answer
1/1 people found this helpful
Was this answer helpful?
YES
NO
Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Need some more details kindly consult
Answered
Flag this answer
1/2 people found this helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.