Hi doctor, I am a medical student doing my internship. My father has been suffering from fever since seven days up to 101 F. I have given him Ofloxacin 200 mg 2 times a day. But, the cause of the fever is unknown. All the blood reports are negative. He is a known diabetic since 20 years and his blood sugar is not under control. His fasting sugar level is 200 mg/dL and after meals 400 mg/dL. He was taking Insulin 2 times a day in the morning and at night. Since his sugar is not under control he is taking it thrice a day now. I have decided to give Metformin 500 mg with insulin in morning and Glycomet-GP 2 during lunch and Insulin as well as Metformin 500 mg in the night. Sugar level is getting controlled to 108 mg/dL fasting and 256 mg/dL after food in the morning but in dinner before food it comes to 333 mg/dL . I have decided to change to Glycomet-GP 3. I need your opinion. Please tell me which antibiotic to be given for fever? And which anti-diabetic to give to control blood sugar? Thank you.
Hello. Parasitic infection or a viral infection or occult bacterial infection. 1. Please have a discussion with his treating doctor and get any specific tests done to confirm a suspected clinical diagnosis. 2. Any change in antibiotics can be done only after close clinical evaluation. 3. Get a complete blood count and peripheral blood smear done. 4. Chest x- ray. 5. Ultrasound scan of abdomen. 1. Confirm the diagnosis of fever with specific tests. 2. Antibiotics to be changed after isolating organism and doing culture and sensitivity. 3. Diet should be strictly followed. 4. Close monitoring of blood glucose level to be done at specific time every day. Revert back after investigations to a general practitioner online.--->