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Doctors' Answers to "Frequently Asked Questions" - Antibiotics
These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.
Minocycline Usage [posted
Question: I am trying to get information on the prescribed
drug...minocycline. My fiance went to the doctor for a rash on his back and severe break
out of acne on his chest. The doctors took a biopsy, told him it may be skin cancer, and
told him they would get back to him within the week. In the mean time, he was prescribed
minocycline for the next 11 months. I have been doing some research on this medication and
i have yet to read anything good about it. Is monocycline primarly used just for acne? Can
you give me some positive feed back on minocycline or should we consider another
alternative? Or can you give me an idea of where i can go for better information? Thank
you so much for your time.
Answer: This drug belongs to the tetracycline class of drugs, which we
use often in the treatment of acne vulgaris. It is usually effective in small doses and
tends to have few side effects. However, sun sensitivity, nausea and occasional diarrhea
are the usual limiting problems. It is often used in chronic dosing for acne;;but, there
are alternative treatments.
More Longterm Antibiotic Treatment
Concerns [posted 11/17/98]
Question: Can vision problems occur from long term antibiotic therapy? I
was on eight week therapy of Gentamicin and Ampicillin following an infection in my knee
Answer: Not usually. Hearing yes, vision would be very uncommon if at all.
Longterm Antibiotic Treatment Concerns [posted
Question: I have been taking Sulfameth/Trimethoprim 800/160 Tabs ( 1 Tablet twice
daily) and Clindamycin 150 mg caps (2 capsules three times daily) For the last three or
four years to treat a Stapf / Strep infection I got during a total knee replacement. My
question is how is this going to affect my body over the rest of my life. I'm told I have
to take then indefinitely. I have noticed that my teeth have started to decay quite badly
since starting these medications. Could they be responsible for the decay in my teeth? And
what other side effects do I need to prepare myself for. I'm 40 years old and in otherwise
Answer: Have you tried stopping the antibiotics? Three years without symptoms
would be a good time from my perspective. They shouldn't be affecting your teeth. There
should be no major side effects except possibly diarrhea.
Antibiotic Reaction [posted
Question: I have been given an antibiotic to fight against a severe ear and throat
infection. The name on the prescription bottle reads "ERYC 333 MG". I am
supposed to take 1 capsule 3 times daily. I have now taken 3 capsules and have developed a
slight rash on my chest, neck and back with some itching. Would this be an allergic
reaction? Should I continue or discontinue the use of this antibiotic? What family does
this antibiotic belong to? Just to let you know, I developed a similar rash when taking
the antibiotic "PenV". Hope to hear from you soon!
Answer: This is time release erthyomycin a macroglide class of antibiotic.
Possibly an allergic reaction, most people would tell you to discontinue the antibiotic.
No relation to penicillin.
Antibiotics & Alcohol [posted
Question: If you are taking tetracycline as a preventative treatment after minor
surgery, can you drink alcohol in moderation, or not at all? Would it diminish the effects
of the drug if you did, or cancel them out altogether?
Answer: Shouldn't be a major problem if in moderation, both can cause
gastritis-about the only serious problem.
Antibiotic Side Effects [posted
Question: Can antibiotics cause pain or agravate an existing problem? I have
plantar facitis in both feet and twice now when i have taken bactrim I have experienced
severe pain in my feet immediately following the first couple of doses. I asked my foot
doctor about this and she thought it was coincidental but when it happened the second
time, i really feel the bactrim is having some tpe of adverse side affect. do you have any
info on the adverse affects? thank you very much!
Answer: Off hand can't say why, but, if it is repeated, I'd suspect its real.
Not a usual problem.
Question: Are there any hospitals currently substituting ceclor with another oral
cephalosporin, and which one?
Answer: Most hospitals go with the lowest cost alternative to equivalent drugs
in a class. As a consequence, each hospital tends to use either low cost generics or have
individual contracts with companies to get the lowest cost. There is no one drug they use,
except the most cost effective.
Skin Rash caused by Tetracycline
Question: About 10 yrs. ago I was taking tetracycline and was sun bathing at the
same time. Now, whenever I go out in the sun and get just a light burn I break out in a
rash that lasts at least two weeks and itches real bad. Usually where the rash is it will
make my glands in that area swell up. Am I just hopeless and just need to stay out of the
Answer: Unless you are still taking tetracycline, this is unusual. I'd have your
physician check for other problems like lupus, porphyria, etc.
Antibiotics and Vaccines
Question: There has been a lot of media coverage lately concerning bacteria which
have developed a resistance to antibiotics. Is there any reason why it would be medically
impossible (or highly unlikely) for viruses to develop a similar resistance to vaccines?
Answer: Viruses also develop resistance to antibiotics like bacteria. This is
especially seen in treating HIV patients where the virus can easily develop resistance to
some of the treatment drugs. However, this is to antibiotics not vaccines. Vaccines
develop anti-bodies which directly attack the organisms(bacteria or virus). There does not
appear to be much resistance to this mode of attack. Bacterial and viral organisms will
develop defenses to chemicals(antibiotics) and their mode of interfering with the
organisms life cycle-- often by passing small bits of DNA or RNA back and forth to each
other. There is a marked difference between resistance to chemicals and resistance to
Antibiotics - Ceftin
Question: My doctor surgically removed a small, dark freckle from my skin, thinking
it might be cancerous. I am in good health and have no infections. The doctor gave me
Ceftin samples and advised me to take one tablet twice a day (he gave me 3 days worth). I
asked if I was supposed to take these only if I got an infection, and he said no. He
wanted me to take the Ceftin to prevent an infection. I have read the long, fine print
document for this drug, and nowhere does it refer to using it to prevent an infection. I
ask because I have heard that you shouldn't take antibiotics unless you really need them,
as the germs can become resistant to drugs. Please advise what the conventional wisdom is
on this issue.
Answer: This type of antibiotic is commonly used when the integrity of the skin
is broken to ensure that bacteria do not begin to spread in the wound area. This is a
usual and custom practice for most physicians. Short term use will not be expected to
produce resistant strains of bacteria.
Question: My wife and I will be traveling to Mexico (Cabo San Lucas). My wife wants
to take a prophylactic regime of antibiotics upon starting our trip. Is this recommended
by the experts?
Answer: There are several schools of thought. It depends on how much fresh fruit
vegetables. etc. youll be consuming and how critical is the trip. If you limit your
intake to bottled beverages and cooked food (no uncooked fruit or vegetables), the risk of
diarrhea is small. If you then develop diarrhea, take antibiotics(there are several
regimens). On long trips this may bepreferred. Some people take the antibiotics daily to
avoid diarrhea, but be advised that most have potential sun sensitivity and you can ruin
your trip with a sun rash/reaction. I usually advise taking the antibiotics and taking
them at the first sign of diarrhea.
Question: I was recently dignosed with H. Pylori and was put on a 7 day regimen of
Biaxin, Flagyl, and Prilosec. 3.5 days into this I started experiencing severe dizzy
spells. I stopped the meds, but 1 week later I am still very dizzy and the back of my head
feels very tingly. Doctors opinions are ambiguous. My personal physician wants me on Xanax
and the gastroenterologist wants me on nothing. He says the meds are still in my system
and need to wear off. I did see an emergency room doc and he said the antibiotics should
be out of my system by now. I am 40 and otherwise in good health. I did have complete
blood/urine analysis and head MRI-all normal.
Answer: I would have difficulty trying to find a mechanism to explain lasting
headaches from the antibiotics. It is possible that your inner ear my been affected; but,
this would be unusual with these drugs. They certainly are "out" of your system
by this time. I would probably consult a neurologist about the "dizzy" spells.
Question:I was given a prescription for Trimox (Apothecon) to take prior to dental
work. Will this help my sore throat?
Answer: Trimox is a brand name for ampicillin. This is a penicillin like drug
and is effective for treating sore throats(pharyngitis) due to bacteria called
Streptocci-or Strep throat. Antibiotics are given before dental procedures to protect the
heart and heart valves against infbction by bacteria dislodged during the cleaning
process. These bacteria in general belong to the same family -the Streptocci foamily- and
are usually very sensitive to penicillin like drugs.
Question: When starting a patient on a po antibiotic if there is going to be a
reaction in what time frame does this normally occur?
Answer: Depends on their allergy. Very allergic patients can have respiratory
arrest within minutes of taking antibiotics. Less allergic patients will develop a rash up
to two weeks after cessation of the antibiotics. Most patients are in the middle.
Question: Would you need to monitor vital signs on individuals for a three day
duration that are starting on a po antibiotic? Is there a rational for this? The setting
is a extended care facility.
Answer: Not usually, but, the vitals may be necessary due to the original
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