What Antibiotic Should I Have Just in Case?
Many of you have written that you have gotten scrips for antibiotics that you keep handy just in case you start to see signs of cellulitis so you can start antibiotics immediately. My PCP did write me a scrip last year for Cipro which I filled when I was going to the Caribbean where access to care might be problematic. Fortunately I didn't need the pills. I've hung on to them, but they are a year old now.
My PCP is wonderful about writing scrips for my LE when I need them, but last year she wasn't sure what antibiotic might be best. We ended up going with Cipro, but is there another one that might be better for LE-related cellulitis? I'm seeing my PCP Monday afternoon and would like to request another scrip.
What do you all keep on hand?
Comments
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My allergist suggested doxyclycline for a backup of choice, but I'm not sure why.
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Mary, the point is to use a broad-spectrum antibiotic that will take out a wide range of bugs. I have augmentin on hand because I had problems with Cipro, but some use Keflex instead.
It's important to find out what other instructions your doctor has about self-administering antibiotics. Mine wants me to check in with him -- from wherever I am -- as soon as I start them, so he can oversee the situation.
Let us know what your doctor decides.
Be well,
Binney -
OK, so it sounds like Cipro might be a pretty good choice. My PCP doesn't know much about LE, but bless her she is willing to learn, and she basically asked me last year if I knew if one antibiotic might be better for LE than another. Since I didn't have any specific info, she went with Cipro as a broad spectrum. Sounds like her instincts were good.
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Mary, the usual bugs in cellulitis are strep and staph, and Cipro tends to cover more gram negatives, so it's not the usual first line drug for cellulitis--in the quinolone class, levaquin would hypotheticaly be better. But, that said, it quite often works very well.
The usual drugs for cellulitis are : keflex (or any other first or second generation cephalosporin), amoxicillin, augmentin
In this day of MRSA, some doctors start with bactrim
Doxycycline is a good older drug, a little slower to work.
I just looked it up on uptodate, and they suggest other alternatives are clindamycin, or one of the macrolides---erythromycin, zithromycin.
They talked about using two drugs, because of MRSA (methicillin resistant staph)
Bottom line: all good options
1) Keflex or similar
2)Amoxicillin--high dose
3) Augmentin
4) Quinolone: cipro, levaquin, avelox
5) Clindamycin
6) Bactrim
7) Doxycyline
8) Macrolide
and there's a really expensive drug--linezolid, that works very well.
My PCP sounds like yours, willing to learn and always backs me up. There was a Medical Letter about expiration dates, and drug potency is usually quite good for several years. The exception is doxycyline or the tetracyclines which form toxic stuff as they break down.
http://www.doctorsolve.com/blog/2010/01/drugs-past-their-expiration-date-are-they-safe-to-use.html
Way too much information, I know, sorry.
Have a great trip.
Kira
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Kira - thanks for the info. You always come through with complete info - exactly what I wanted to know. I'll ask for Keflex or high dose amoxi tomorrow.
Bless these PCPs who trust us and are willing to learn.
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