Hello and thank you for the question. Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a practicing Internal Medicine Specialist and i will do my best to help you today.
You need to answer a few questions first which will help me assist you in a better way.
What kind of test did you have?
Did they take the urine sample for culture?
Any concurrent medical illness you have?
Thank you very much for the useful information Mona.
You have taken Z-pack, and Bactrim (for 3 days) as well with no response in your symptoms.
Two points are very clear here.
First you do have an infection in the body giving you chills, fever and related symptoms, but off-course we do not know whether it is predominantly your tooth abscess or urinary tract infection giving you these symptoms, or a combination of both.
Secondly, your infection has not responded to the antibiotics you have taken, suggesting that either the choice of antibiotic was not appropriate or there is a possible resistant infection.
Its better that you should be switched to a broad spectrum antibiotic which will cover all the possible pathogens that can give you a tooth abscess as well as urinary tract infection.
Quinolones, like ciprofloxacin or levofloxacin are good antibiotics for this purpose.
Amoxi-clav is also great.
Ideally you should have a urine culture test done as well, which help to exactly identify the causative bug responsible for the infection, and will also identify the antibiotics which will work best against that bug.
At this point you should wait for another 48 hours (giving bactrim a total of 5 days) and watchfully monitor yourself for any improvement in your symptoms.
Use cranberry juice (has a protective role in urinary tract infections).
Drink lot of water.
And if after 48 hours, the symptoms persist, does not improve or get worse, see your doctor again discussing all the details i have mentioned (for urine culture and broad spectrum antibiotic) to get further management plan chalked out.
I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.
It was a pleasure assisting you and thank you very much for visiting us.
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A clinical examination by the dentist will give a more precise answer regarding the nature of dental problem you have (if this is infected or not) and this will also help the dentist to decide whether he want to proceed with root canal treatment or wait first (in order to treat the tooth infection --- if it is present).
Also we can not overlook the urinary tract infection for which you need a repeat urine examination and culture.
You need not to panic as many a times people get infections simultaneously in different areas of body --- but these can be treated adequately.