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Antibiotic question - somewhat urgent

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Posted 4/26/2008 12:23 AM (GMT 0)
I was prescribed Cephalexin (Keflex) for a sinus infection and just took my first pill.   I did some additional research and found several mentions of this being particularly irritating for UC patients.     This was very alarming: Make sure you tell your doctor if you have any other medical problems, especially: ·          Bleeding problems, history of (cefamandole, cefditoren, cefoperazone, and cefotetan only)—These medicines may increase the chance of bleeding. ·          Stomach or gastrointestinal disease, history of (especially colitis, including colitis caused by antibiotics, or enteritis)—Cephalosporins may cause colitis in some patients.   It’s Friday.   I’m not going to be able to talk to a doctor or get a new prescript ion until Monday.   Should I stop taking it?   Continue taking it and hope nothing happens?   My next dose is due tomorrow morning, and I do not know what I should do.     Any suggestions would be appreciated.
Posted 4/26/2008 1:02 AM (GMT 0)
Pessimist, antibiotics don't cause UC, but they can lead to flares because they kill off the normal bacteria in the colon. I'm not going to recommend you stop taking them, because then you could end up with a worse sinus infection that's drug resistant, and only you can decide to take that chance. Do double up on your probiotics, taking them at least two hours after the last antibiotic of the day.
Posted 4/26/2008 1:17 AM (GMT 0)
I second Judy's recommendation about the probiotics. If you're not on any at least eat some yogurt to help counteract the antibiotics side effect. In the future, be sure to tell you your doc about antibiotics and your Uc with it's contradictions. Hopefully then, the doc can give you a more gut friendly version.
Posted 4/26/2008 1:20 AM (GMT 0)
I have had tons of sinus infections in the last year and always taken antibiotics. If you want to double check w/ the GI you can call and have the doctor on call for the weekend give you a call back. I've done this before just to get the a-ok to take them.
Posted 4/26/2008 3:59 AM (GMT 0)
I had an infection last month (female related), I was already having a flare. Urgent care Dr put me on 1000mg Cephalexin twice a day and I ended up with C Diff. This was really, really awful. I sincerely don't want to scare you, but I'd hate for anyone to go through what I went through. I hope you can get it cleared up without getting any uc complications! And, probiotics possibly from a naturopath, I understand that these can be a lot stronger than the ones available at health food stores. I hope this helps. Good luck.
jenjim
37, uc since 1998
Posted 4/26/2008 5:17 AM (GMT 0)
I've heard that there was such a thing as antibiotic induced colitis, but I'm not well rounded on the low down of it.

:)
Posted 4/26/2008 5:20 AM (GMT 0)
antibiotic induced colitis is usually c.difficile...it goes away once treated.


NO, don't stop taking them....

make sure you're taking probiotics.

They can also help with sinus infections.

quincy
Posted 4/26/2008 5:23 AM (GMT 0)
Assuming that you're in the U.S., your doctor's office should have an answering service for weekends and nights. You can call and ask the answering service to have your doctor (or if it's a group practice, the doctor on-call) get back to you. It would be a shame to worry all weekend if someone is available to call you for 2 seconds and answer a few questions.

I assume that the prescribing doctor was not your GI? If that's true, then you might want to call your GI's office instead. I don't like to take any antibiotic without making sure that the prescribing doctor takes into consideration that I need the most UC-friendly antibiotic that will work.
Posted 4/26/2008 8:38 AM (GMT 0)
I agree that the antibiotic induced colitis is most commonly referring to c-diff colitis. If you're taking an antibiotic at home, it's not as likely to get a c-diff infection as if you're on antibiotics in a hospital - it's a common hospital infection because the bacteria is prevalent there, and much less so outside of hospitals. I differ with one thing said above about how it goes away once treated; once contracted, c-diff can be difficult to shake, although true I guess it does always go away - just can take years for some people. I got it when hospitalized last year and it took four courses of treatment over about 5 months before it stopped recurring. It reproduces through spores that while dormant are immune to the drugs that kill the bacteria, so it can recur quite easily.
Posted 4/26/2008 10:54 AM (GMT 0)

Thank you all for your responses.  I will continue to take the antibiotic for now.  I will also call my GI today to speak to the on call doctor to see if they think I should switch.

 

I will also pursue probiotics.  I do not currently take any, mostly because I have seen so many different recommendations that I was unable to decide what might work. 

 

My primary physician was the doctor who prescribed this antibiotic, and he does know that I have UC.  None of the information with the prescription indicated any issue, nor was the pharmacist able to find anything when I called him last night.  It’s troubling that I can get more information in a two minute web search than anyone in the medical industry can get with all of their resources. 

 

Why is a barcode scan required when I buy a pack of gum, but prescriptions for serious medications are dispensed by a person scratching on a scrap of paper?

 

Why do the patients have more knowledge about UC than most of the medical professionals who treat them?

 

The medical industry is about 40 years behind in leveraging technology and data.        

Posted 4/26/2008 11:15 AM (GMT 0)
Just wanted to ad one more thought. I'm not sure on getting C diff in or out of the hospital (I was out), but I would second the person who said that once you get it, it can take a while to get rid of it because of the spores. Contacting the Dr on call sounds great. I am thankful, but a bit disillusioned at how (because I have noticed too) that I can get more info from the web than from my Dr, pharmacist, etc.
jenjim
37, female uc since 1998
Posted 4/26/2008 11:22 AM (GMT 0)
I would highly recommend a probiotic. Since you need it NOW, I would suggest Culturelle. It's widely available at Wal-mart and many of the Rite-Aid/Walgreens/CVS pharmacies. Acidophilux Pearls is another one that is easy to find - but I personally haven't used them.

Take your probiotic 2 hours before or 4 hours after your antibiotic.

Once you get used to the probiotic, you can increase the dose. You may initially have extra gas and bloating until your body adjusts to the probiotic. Usually goes away in a few days.

Best of luck!
Posted 4/26/2008 11:26 AM (GMT 0)
I wanted to add that I share you frustration about the information patients received about their prescriptions.

Recently, I started Ambien. No where in the literature the pharmacy gave me did it state anything about taking it on an empty stomach or it not working. No note on the prescription bottle. No one from the doctor's office or pharmacy said anything. It was only after a night of NO sleep that I looked it up online and found that. One darn cookie with my antibiotic and I couldn't sleep!

Had a simialar experience with Flagyl. No one in the doctor's office or pharmacy told me it could cause a super "spacey" feeling. I only found out through this forum! Wow was I relieved to know what it was and that it would go away when I finished the meds.

I'd also suggest irrigating your nasal passages with saline spray while you have the sinus infection. Helps moisturize and clean them out.

Feel better soon :)
Posted 4/26/2008 11:32 AM (GMT 0)
As for all those with the chronic sinusitis problem, my doctor put me onto a product called Fess.

Its basically a saline wash for the nose and sinus cavities. There are a few versions of it.

I have had awesome success with the "water bottle and sachets of hyper-saline solution" version of Fess.

Since I started cleaning my sinus' every other day, I have not had any of the sinus headaches or infections I used to get, even though I am now MORE heavily immune suppressed.

As anyone who reads my posts knows, I am *not* a big fan of alternate therapies, but this one has worked a treat for me - I tried it as I could find some solid scientific basis behind the idea. Here is the Wikipedia article and anyone interested in the Fess product can google it easily enough. Good luck.
Posted 4/26/2008 12:50 PM (GMT 0)
My allergist put me on saline irrigations, too. I just mix my own saline at home and use a regular bulb syringe. It finally cleared up the chronic, hacking asthmatic cough that not even steroids could do away with. I still do it daily. I don't get sinus infections, but I haven't had a nose bleed or the cough for five years now.
Posted 4/26/2008 3:49 PM (GMT 0)

Thanks again everyone for sharing information and suggestions. 

 

I did reach the on-call doctor, and it just happened to be my doctor this morning.  He said that it is “absolutely false” that Keflex would create issues for someone with UC.  He urged me to continue taking the antibiotic, and like everyone here he suggested taking a probiotic. 

 

The pharmacist suggested Florastor, so I will start taking that later this afternoon.  I’ll also make sure that I increase my yogurt consumption for the next few weeks. 

 

For several months at the beginning of last year, I used saline nasal spray.  I stopped when I got my UC diagnosis because I did not know if they might be related.  I should probably resume now.    

Posted 4/27/2008 1:32 AM (GMT 0)
Just another option - my primary doesn't like putting me on any antibiotics because it can irritate my crohns. When I get a sinus infection I get prescribed a steroid nasal spray. The infection takes longer to go away than with an antibiotic but does go away within a few days of the spray.
Posted 4/27/2008 11:53 AM (GMT 0)
No doctor of mine would ever think of prescribing me Keflex...now! I had some older doctors not too long ago that insisted that certain antibiotics were safe for me. So I would trust them and take them only to end up in a miserable flare. This is before I started probiotics. Now I am with a doctor that totally understands Uc and it's complications because her mother had it so of course she learned all she could about it. Once I had an infected cyst and my regular doc was away so I seen her associate. He told me to try Omnicef so I did only to end up with massive watery D all weekend. I then called my regular doc on Monday and she told me that Omnicef is has been known to cause D in some people and told me to stop asap. So in short, docs don't know everything especially on how a Uc'er or even a normal person is going to react to a certain antibiotic. Of course you have to deal with the antibiotic since you have a sinus infection but as long as you take precautions then things should be fine. Just a FYI, Uc'ers should avoid any of the 'cyclines and 'cilians. These have been proved to cause c. diff.
Posted 4/27/2008 12:19 PM (GMT 0)
Remember, you may be the only patient with IBD your primary doctor treats. Mine has two patients with UC. With all the diseases they have to deal with, I was surprised that my primary picked up on the UC right away. I really don't expect her to be up on all the ins and outs of a disease she sees twice in her practice.

All of my doctors and dentists ask me what antibiotics I can take. That simplifies things. I know I can take Cipro and Azithromycin. I know I can't take 'cillins, 'cyclines and other mycins. I've been very lucky in that I don't need antibiotics often.
Posted 4/27/2008 9:56 PM (GMT 0)

Pessimist said...

I did reach the on-call doctor, and it just happened to be my doctor this morning.  He said that it is “absolutely false” that Keflex would create issues for someone with UC. 

I've heard that Keflex can cause issues for UCers. It doesn't mean it will necessarily cause issues for everyone with UC, but the possibility is there and for your doctor to say it is "absolutely false," is, well, absolutely false. At least he agrees probiotics are beneficial for us. My doctor denies they do anything and told me to stop taking them.
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