Alternative to penicillin for prophylactic antiboiotics

[tom in MO]

I lost about 6" of my colon in Wallmart... Joke. I did lose it, but in St. Luke's Hospital.

As a result, sometimes my bowel is irritable, particularly after 2g of penicillin for teeth cleaning. My colon whistles Dixie so loud, I am sure people close by can hear it. I also go from constipation to loose bowels, sometimes having to resort to small dose of an opiate related pain killer to calm things down. It takes a couple of weeks for things to settle.

I talked to my cardio and he said there were other options. This time I tried Keflex or cehpalexin and I did not have the huge disruption that I get with penicillin. So, if you suffer from the prophylactic antibiotics, there are other options that may be easier on you.

 

[Paleowoman]

I take Azithromycin 500mg for dental prophylaxsis.

I'm 'sensitive' to penicillin, that is I get bad reactions to it but I'm not strictly allergic to it - after tests the specilaist I saw said I should not be given penicillins unless I'm in hospital being given a graded desensitizing dosage - obviously that wouldn't work for prophylaxsis, hence the Azithromycin. Here's a pdf of all the various antibiotics for prophylaxis: http://www.heart.org/idc/groups/hear...ucm_307684.pdf

PS - if you're in the US dental prophylaxsis seems to be usual but in the UK you may have to push for it as NICE guidance doesn't recommend it.. My cardiac surgeon says I need dental prophylaxsis and my GP agrees (so did a maxillo facial surgeon I saw who extracted a tooth) so I have it on my repeat prescription list to request any time I think I might need it.

 

[ALLBETTERNOW!]

Clyndimiacin or something like that is what I get. Big dose 1 hour before appointment

 

[pellicle]

Hey Tom, sorry to hear that.

how about Augmentin?

 

[Paleowoman]

how about Augmentin?

Augmentin is amoxicillin and clauvanic acid so would be a no-no for someone who can't take penicillin due to the amoxicillin.

 

[pellicle]

Augmentin is amoxicillin and clauvanic acid so would be a no-no for someone who can't take penicillin due to the amoxicillin.

Yes, I knew that . But I have a mate who seems to have problems with penicillin but not with augmentin. Who knows evactly what the gripes are caused by ... ?

For what its worth I've been on amoxicillin for 3years nearly and its not caused me any reactions.

It is slightly different to penicillin iirc
https://en.m.wikipedia.org/wiki/Amoxicillin

 

[Paleowoman]

Yes, I knew that . But I have a mate who seems to have problems with penicillin but not with augmentin. Who knows evactly what the gripes are caused by ... ?

I was on courses of both amoxicillin and augmentin earlier this year and had the same reactions with both which increased in severity with each course, hence I was referred to immunologist who did various tests to find out if I was allergic to specifically amoxicillin or penicillins in general. I suppose a person needs to find out if they are having a "side effect", a "sensitivity which may indicate a problem" or an outright "allergy" if they get repeated reactions to the same type/class of antibiotics. Better to be safe than sorry when taking a prophylactic dose of an antibiotic !

 

[tom in MO]

I don't have any allergy, the massive dose just disrupts my bacterial colony too much and takes too long for it to come back to equilibrium. A normal course of the antibiotic is fine, it's just the massive dose that disrupts my colon. It used to be just annoying and I stopped doing it before the valve replacement since the recommendations had changed. After the valve replacement, prophylactic antibiotics appeared to be more "required" but after about a year or so, my colon started to really dislike it. Thanks for the suggestion of Clyndimiacin if the Keflex starts working "too well" I will ask again and discuss that drug.

Per "Skigirl" (IIRC) recommendation, I also request the dental hygienist to let me rinse my mouth out well with her Listerine before any cleaning. Why not kill the bacteria before they enter the blood?

 

[pellicle]

Per "Skigirl" (IIRC) recommendation, I also request the dental hygienist to let me rinse my mouth out well with her Listerine before any cleaning. Why not kill the bacteria before they enter the blood?

the problem is that will not get subgingival bacteria and those in the plaque when doing cleaning procedures. It sure won't hurt, but it would need to be continually drizzled in as more is uncovered.

would having the dose spread longer rather than a spike help? For instance take two 500mg tabs of amoxycillin (does that upset you too?) followed by one per 8 hours for the next 24 hours. That would give you a longer residual time of antibiotic in your system.

 

[Paleowoman]

And get a good protbiotic bacteria to take after the antibiotics to re-populate your bacterial colony in your gut.

Re the killing of oral bacteria - I had a tooth extracted earlier this year in hospital. I had to don a gown and everything but no oral rinse. I asked the theatre staff why they didn't disinfect my mouth since everything else had to be so sterile. The answer was that there are so many different strains of bacteria in the mouth that it's impossible to sterilise ! This got me really interested in probiotics for the mouth - they exist too as well as those for the gut. http://www.drbicuspid.com/index.aspx?sec=spt&sub=apr&pag=dis&itemid=309686 I now take a specific oral probiotic to help keep a good colony going in my mouth (till another antibiotic course).