Antibiotics - some balance

Nick-H

Yes, that is my observation too.

It seems to happen because...

--- patient is not satisfied if Doctor does not prescribe lots of stuff.

--- patient will not lay out money for 5 days pills without finding out if they do any good, preferably on day 1.

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edwardseco

Easy solution, provided to me by a doctor in India as an aside to treating a rich patient in a village, just give a shot of B12 (placebo)..

grikoo

My personal way of treating diarrhea:

1) Wait and see if it continues throughout the day, there's no need to do anything for the occasional bout of light diarrhea or loose stools.

2) If it continues to worsen throughout the day, or has blood in it from the start, start taking pepto-bismol (bismuth subsalicylate). This is a far under-rated first line drug. In addition to stopping diarrhea, it also quells nausea, is anti-inflammatory in the gut, and somewhat anti-biotic. Take 1-2 pills every hour until it stops. I think there's a maximum daily dose of 16 pills in a day, so don't go over that. Don't take aspirin with it, as salicylate toxicity can be a serious problem. Also, don't take pepto within 3 hours of doxycycline as it interferes with it's absorption (so if you're on doxy, you'll want to take your pill before starting a pepto regimine.)

2b)Levsin (hyoscyamine) is also a very under-appreciated drug. It acts as a smooth muscle relaxant throughout the digestive tract and lessens or alleviates the cramping and uncontrollable urges that go with severe diarrhea. It's usually supplied in .125mg, sublingual tablets. Take 1-2 tablets every 6 hours as needed. It's a tropane alkaloid, so don't overdose on it, but I've taken quite a few before without any noticeable side effects. Also, don't take it with loperamide (immodium), as the effect will be to shut down your digestive tract completely, which isn't good. I generally recommend against loperamide anyway, as it can cause problems and has lots of drug interactions. Levsin should also not be taken with other anti-cholinergics, such as certain classes of anti-nausea medication. For the purposes of this treatment method, you'd only need to stop taking it before you take tinidazole. This is not because of any known interaction, but just my advice as tinidazole is a very strong drug.

3) If the above pepto regimine doesn't provide relief after 1 day, begin taking Cipro, 500mg, twice daily, for 2-3 days. This will normally knock it out after the first day, but take it for at least 2 days to be sure. Take care that you're not becoming dehydrated. Oral Rehydration Salts, diluted soda, or a salt/sugar solution are all options. Dilute fruit juices are good as well. Gatorade and sports drinks must be diluted as they are too sweet. Bananas and rice are good snacks if you can eat, as they replenish potassium and provide bulk. If you are vomiting, you can still sip about 1 tbsp of liquid every minute or so without triggering it.

4) If you still have symptoms after 3 days, continue the Cipro for 2 more days.

5) If you're still sick, you can assume you have parasites. Either go to a doctor to get tested, or stop taking Cipro and Levsin, wait a day (unless you're about to die), and take 2g tinidazole in a single dose. This should clear up most parasites, and is highly effective against giardia, which is the most likely culprit. Metrodinazole is also an option at 250mg, 3 times daily, for 7 days, but it's no fun at all, so go for the single dose of tinidazole (also no fun, but much shorter). Some guides I've looked at recommend Furolazidone, as it treats parasites as well as bacterial diarrhea. However, as this drug is also an MAOI (monoamine oxidase inhibitor) and overall less effective at treating parasites, I personally recommend against it.

6) At whatever point you stop treatment, wait a few days and then begin taking yogurt, lassis, etc (no ice in the lassis). You should wait a few days because traveller's diarrhea often induces acute lactose intolerence, which might cause more diarrhea and cramping and confuse your actual condition. For this reason, you should avoid dairy while you have severe diarrhea, as it may unnecesarily aggravate it. Paneer isn't too bad, as lactose is water soluble and gets pressed out with the whey, but you should avoid milky things, particularly sweets. If probiotic supplements are available, you can start taking those as soon as you stop taking antibiotics. Take them for at least a week.

Other useful antibiotics:

I usually carry a 14 day course of cephalexin, which will treat urinary, skin, ear/nose/throat infections, and bronchitis. Dosage is generally 250-500mg, every 6 hours for 10-14 days. Dose and length are determined by the severity of the infection.

amarama

It is my limited understanding that the way an anti botic works is by creating a stress on the body greater than the infection. Thus the body stops fighting the original infection and moves on to the anti botic. Voila-your cured. If someone has a better understanding than this I would welcome it.
Someone mentioned that Doctors are in the dark about anti biotics, that is not true. Many doctors are fully aware of the dangers, but are more aware of what a medical malpractice law suit can mean! From example. if I go to my doctor with Broncitis of the lungs, and they do not prescibe me anti botics, Lawsuit. Anti botics do absolutly nothing for broncitis.
The true about the new breed of anti botics is recently coming to light. I was so surprised to read that this powerful new class can cause major health complications.
If it was not for anti botics I would have lost my leg do to infection. Although the alternitives definetly need to be pursued. I am very interested in these b-12 shots.

grikoo

Yes, that's somewhat right, but there are a wide range of antibiotics and each class has it's own unique method of action.

Having been cured of bronchitis several times as a child and early adult, I must disagree with your assertion that antibiotics do nothing for it. It's true that there are forms of bronchitis caused by viral infections, and antibiotics will do nothing for those, but there are also bacterial causes which antibiotics will help. Especially in India, and certainly during the wet season, I'd be very worried about not treating bronchitis. You could easily end up in the hospital with pneumonia.

Even in the case of viral bronchitis, antibiotics will help avoid secondary infections.

I think what edwardseco was talking about, was a doctor administering B12 instead of actually giving treatment. It makes you feel good for a few days, as any strong B complex would, but doesn't really cure anything.

A good B complex IS something to consider having though, as B vitamins are particularly likely to be deficient due to the way Indian food is cooked (and westerners inability to safely eat as much fresh fruit and veggies as we like).

Nick-H

Hmmm... My (also very limited) understanding of how antibiotics work is quite different.

Simply put, they are a poison. The idea behind a lot of anti-bacterial treatment is to kill the bacteria without killing the patient. It is like using an insecticide that kills the mosquitoes in a house without killing the people.

The antibiotics themselves attack the infection. They give your body a helping hand.

Thus far in the analogy they are entirely benign, but we do not live in a world of perfect science, and those antibiotics may attack some of our body's cells as well. Most commonly they can wipe out the good micro-organisms in your gut as well as the ones they are supposed to be killing.

It's a case of balances. You want the wiring fixed? there's going to be some damage to the paintwork. The more serious, and perhaps potentially lethal, the disease, the bigger the risk one might take to cure it.

A friend of mine has just been through weeks of nightmare agony to treat a cancer she was previously hardly aware of. Frankly, I think I might have just curled up and died. She would probably be dead now if she had not undergone the treatment.

Anti-biotics are wonderful. But if more people regarded them as dangerous poisons they might be abused less!

grikoo

My understanding is that you are both right.

I think what she's talking about are actually 'immunogenics', which create an immune response capable of attacking the illness. Vaccines made from various organisms work this way, but my understanding was that the production of specific antibodies via chemical triggers is also possible. I'd assume though that treatments of this sort would be highly specific, and require diagnosis first.

But yes, like insecticides, most antibiotics work either by killing the beasties outright, or by inhibiting metabolic pathways or reproduction.

I used an insecticide in my greenhouse that shuts down the digestive tract, in effect starving them to death. Not very nice to think about.

edwardseco

Cures loneliness, etc. A study of the British Health Service reported that 10% of the visits were for such causes! As lon as its for free..