ER visit & Question for Al

[geebee]

Hi all,
I spent about 8 hours in the ER yesterday. I have been sick since Wednesday (started with a sore throat - I was exposed to strep so the doc started me on Keflex). By Friday night I had a huge case of coughing up crud, SOB, a fever of 101, stuffed head, runny nose, etc. etc. etc.
Saturday around 4PM, I woke up from one of my 1/2 hour naps (all I could get in with coughing), got up to get something to drink to take my meds and promptly passed out on the living room floor. My SO is in Texas so I was here alone. My guess is I was out for about 5 minutes.
I decided to call 911 and go to the ER. They did bloodwork, chest xrays and hung an IV to get fluids in. I was given O2 since my sat rate was 89. My temp was 103 so they gave me tylenol to get that down.
My chest xrays were clear, strep test negative but my white blood count was elevated indicating some type of infection. They are calling it bronchitis but I call it being hit by a truck or turning into a wet dish rag.
Anyway, they sent me home, of course then telling me not to go out, LOL (I guess leaving the hospital is not going "out").
I have a couple of questions tho, the doctor wanted me to stop the Keflex and start Zithromax (sp?). He said the Keflex was not a good antibiotic which really floored me. I have been taking it for years for dental stuff and infections and have found it to work fine.
The other problem I have is I am allergic to many of the new antibiotics (tried each time they came on the market) - Cipro, Clindomycin as well as Vancomycin. I am truly concerned about trying a new antibiotic especially since I am so sick I am not sure I would quickly recognize an allergic reaction.
Does anyone (Al, of course, I would love your feedback) know if people are commonly allergic to Zithromax or has anyone heard that Keflex is no good?
The last issue is my INR was 5.3 - caused a little concern that one. Can Keflex make that big of a difference in INR or am I just on too much coumadin right now. It seems that my INR has been crazy since I stopped using Aspartame a couple of weeks ago. I had to increase my coumadin a couple of years ago around the time I started drinking diet sodas so I am thinking there is a connection.
Sorry to be so wordy. I am a bit worried and things always seem magnified when you are by yourself.
Thanks for listening and smiles,
Gina

 

[Ross]

Yes Keflex can and so will Zithromax. You should be tested 4 or 5 days after starting, but if your already high, I would think even sooner.

http://www.warfarinfo.com/azithromycin.htm

 

[ALCapshaw2]

Hello Gina,

I can relate to your antibiotic concerns. After a couple of years using Amoxicillin, I developed a 'reaction' to it and ended up using Azithromycin (a.k.a. Z-pak, zithromax) with no discernible side effects. Hope it works as well for you.

'AL'

 

[JimL]

When you get sick, your eating habits change, your exercise level changes, and the INR reflects that quickly. That may or may not be the problem, but it's something to consider. If that is the case, when you get better, your INR would come back in line. Be careful about reducing your coumadin too much, or you may end up on the INR roller coaster.

 

[Bryan B]

Gina,

I dug up this on Zithromax and Coumadin, but I think what Ross posted is more thorough and I would abide by his info.

<<Azithromycin did not affect the prothrombin time response to a single dose of warfarin. However, prudent medical practice dictates careful monitoring of prothrombin time in all patients treated with azithromycin and warfarin concomitantly. Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anticoagulant effects.>>

http://www.rxlist.com/cgi/generic/azith_ad.htm

All I can tell you from my limited knowledge in pharmacy (i.e. I'm not an RPh) is that it's not that Keflex is "no good", but that Zithromax is more likely to be effective in fighting the bacteria most commonly found with upper respiratory infections (i.e. bronchitis). Z-Pak was the first antibiotic given to me when I was first diagnosed with bronchitis in July 03. The 5 day regimen they gave me didn't touch my bronchitis and I ended up on a longer regimen of Cipro. As far as having an allergic reaction, I'd rather not venture a guess as to whether your previous allergies to the other antibiotics you listed may make you cross sensitive to Zithromax. If you have ever taken Erythromycin without problems you will PROBABLY tolerate Zithromax.

I hope you're feeling better soon, I know how a bad case of bronchitis really takes the wind out of your sails. And in my case, my infectious disease doc felt it was the probable cause of my endocarditis since I had it for so long and my VSD and prolapsed aortic valve were mitigating factors as well.

 

[Karlynn]

Gina, I'm so sorry to hear about your illness. I don't have too much to offer that others didn't. I will say that it seems that anytime I get sick (which fortunately isn't too often) my INR goes up, regardless of whether I'm on antibiotics - although that bumps it up even more. I think Jim is right about your eating patterns changing, and I would also add that the rate at which you metabolize your warfarin probably slows down too, since your body is working on fighting a bug.

Take good care of yourself!

 

[geebee]

Thanks all.
Just reading your good thoughts make me feel better and less alone.
I still have mixed feelings about trying the Zithromax, I think I will stay on the Keflex a couple more days and, if my fever doesn't go down or the cough improve, I will talk to my GP about switching to the Z-Pack.
The biggest irritation right now is my back hurting from so much coughing. It just seems to go on and on.
Oh well, this too shall pass - eventually.
Thanks again and smiles,
Gina

 

[Bryan B]

Gina,

Your statement about the cough just reminded me of one more thing. My PCP said that although he thought the antibiotics had taken care of the infection in my lungs, the fact that I continued to cough was kind of causing a vicious cycle that was preventing me from getting over the bronchitis. He prescribed a strong cough syrup (M-Clear) and a regimen of steroids...the cough syrup to supress the cough and the steroids to reduce the inflammation in my lungs. This finally helped clear it up for good (although by then the bacteria had set up camp in my prostate, in my blood, and eventually in my valve). My point is that you might want to ask your doc to give you something to help with your cough.

 

[Nan]

Hi Gina, sorry you are feeling so yukky! I'll just pass along my experience with z-pac (Zithromax). I was terribly sick last year, like you, with bronchitis....The z-pac really helped clear up the infection but it also seemed to up my INR considerably! So absolutely get your INR checked if you start it. And I second the other comments about the changes in your diet etc. when you are sick...it can make a big difference in your INR also.

I also ended up having to take a cough syrup to help with the cough...it was one with codeine.

It takes a while to get over, so just take it easy, lots of fluids and rest, and check back with your doc if you feel any worse or don't get better to make sure it doesn't go into pneumonia!

 

[Guest]

I don't see anything to disagree with or have anything to add except to hope that you feel better soon.

 

[geebee]

Bryan,
Thanks for your suggestions. I do have a prescription for cough medicine but I have no way to get it filled (too weak to go out and my SO is still in Texas). However, I am concerned about taking it because I am coughing up so much "gunk" I don't want to take the chance it will get into my lungs. So I have mixed feelings about dealing with the backache from coughing and feeling like I am removing stuff that shouldn't stay in my body. Sorry to be gross but I can't explain it any other way.
I think if the cough gets to be non-productive, I will call my sister and ask her to get the prescription filled for me. She lives 40 miles away so I really don't want to bother her right now.
Thanks for everyone's caring.
Smiles,
Gina

 

[Bryan B]

Gina,

Good point. By the time I found my PCP and he prescribed the cough syrup / steroid regimen my cough was for the most part non-productive. I had gone to an urgent care center twice where they treated me with antibiotics and a steroid shot (depo-medrol). When I found my PCP he felt the infection itself had cleared up but the bronchitis was not clearing up due to the vicious cycle mentioned above. If nothing else, you might want to get it filled and take it at night so you can get a good night's rest. Hope this finds you feeling better.