I'm asking for medical advice on MN

[BeardPotato]

It's a bit U to ask for medical advice from virtual unknowns, but perhaps some knowledgeable MNers could least point me in the right direction.

My question is does dd need urgent care, or do I need to give the antibiotics more time to take effect?

Earlier this year 16yo dd had an abscess in a kidney. She had had no UTI symptoms, just fever and malaise, and severe backache after the antibiotics cleared up the fever. Resulted in hospital admission, IV antibiotics, eventually discharged with an all-clear. But at her follow-up I insisted that dd is not 100%, and they agreed further investigations (due in October).

She now has another UTI. Again, no UTI symptoms, and this time just backache with no fever. GP prescribed co-amoxiclav on Friday, so she's 48h into the treatment and feels no better.

When dd was discharged from hospital, I was told to have a very low threshold for bringing her to A&E - basically to bring her in if she had any fever.

But she has no fever. She just doesn't seem to have responded to the antibiotics yet. IME you notice an improvement after 48h on antibiotics, even if you don't feel completely well.

So what should I do? Wait or go to A&E? Who can I ask for advice?

Take her in

Could you call out of hours and ask for advice? Hope she starts feeling better soon

After 48 hours with no improvement there isn't any advantage to waiting. Take her in.

Given the previous advice you had on having a low threshold for concern I would take her in. It's better to go and get discharged than not and something to be missed.

You can ask 111 or GP out of hours for advice. If you’ve been told to have a low threshold for taking her to A and E, you’d be justified in taking her straight there though.

Medical people at hospital told you what to do- do that

111 on a 1h call-back from (I think) a doctor. Trouble is that she doesn't fit their algorithm, and the call handler could not answer my question re 48h of antibiotics.

Medical people at hospital told you what to do- do that

This ^

Seriously OP, stop second guessing what the ED will say, and just get her seen.

Take her in.

Take her in. We're seeing loads of UTIs resistant to amoxycillin (main component of co-amoxiclav), so may well not be on the best antibiotic.

Another one saying to take her in, fuck 111.

I work in an emergency department and this would be standard for being seen and not getting a side-eye or eye-roll from the triage nurse.

I didn't have the background your DD had but when I had a kidney infection the GP told me to give the antibiotics 48hrs and if I felt no better to go to A&E. I was admitted when I got there

We're at A&E.

Dd, ironically, has perked up hugely.

You were right to go in. I hope she continues to perk up!

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So I took dd to A&E. Bloods and urine - they said she has no infection.

Back to GP on Monday, she refers dd for an US, marks it urgent in the hope that hospital will call dd in before the end of the week.

Today, Thursday, GP call to say dd's infection is resistant to the antibiotics and, given her history and increasing pain, I should take her to A&E now as that is the only way of getting a same-day US to rule out an abscess. Gives me a letter.

Back in A&E. First of all GP's letter is not a proper referral. He should have referred dd to a specific department. Now she has to go through standard A&E processes.

A&E dr doesn't think she's ill enough to warrant an US scan to rule out an abscess. Told me that they don't do scans to rule out, but to confirm diagnosis.