Ask Dr. Gott » antibiotics

Antibiotic not to blame for high blood pressure

Dr. Gott — Sun, 31 Jan 2010 05:01:19 +0000

DEAR DR. GOTT: I am an 80-year-old woman in good health. I am not overweight, walk at least two miles every day, and my blood pressure is normally within the accepted range.
I had foot surgery for a hammertoe and got a small infection in it. The doctor gave me the antibiotic cephalexin, and my foot healed well. Three weeks after taking the antibiotic, I developed a twitch in my left eye, and the following day, the left side of my face was twitching and felt strange. I went to my primary-care doctor to find out what was happening, and he told me that my blood-pressure medicine was not working. He increased the dosage from 25 milligrams to 50 milligrams per day. I told my doctor that I thought it was a reaction to the cephalexin, but he said that it couldn’t be from the drug because too much time had passed from when I last took it to when my symptoms began.
My blood pressure continued to spike, especially in the middle of the night. I felt bad and went to the emergency room at my local hospital and told the doctor there that I thought my problem was from the cephalexin. She asked if I had vomited when I took the medication, and I told her that I hadn’t but did have some stomach upset, which had gone away when I ate soda crackers and cheese to settle it.
Two days later, I went back to the emergency room. My blood pressure this time was 224 over 100 and something. I was immediately admitted because they said I could have a stroke due to having such a high blood pressure. This time I underwent an electrocardiogram (EKG), a chest X-ray and an MRI. They all came back fine and showed no damage, but the doctor thought that I had had a transient ischemic attack (TIA). I was given a prescription for hydrochlorothiazide (HCTZ) and sent home.
I will never take penicillin or cephalexin again, but I would like to know whether there is an antidote for an adverse reaction to the drugs. I even called the 800 number on the bottle to ask for an antidote and was told to call the emergency room.
DEAR READER: I am afraid that you are not going to like my response any more than you liked that of your primary-care physician, the ER physician or the person at the 800 number.
If your symptoms did not start until three weeks after stopping the medication, the cephalexin was not to blame. It would have cleared out of your system by then. According to my “Physicians’ Desk Reference,” 90 percent of cephalexin is excreted in the urine within eight hours of ingesting it.
Reactions to medications occur primarily during the course of treatment or shortly thereafter. Those that induce problems following treatment are typically the result of long-term steroid or narcotic use and due to abrupt cessation, causing withdrawal symptoms.
Adverse effects from taking cephalexin include allergic reaction (hives, swelling, rash), dizziness, fatigue, muscle or joint pain, headache, hallucinations, agitation, confusion, abdominal pain, stomach upset, heartburn/indigestion and more. Typically, stomach upset can be avoided by taking the medication with food or on a full stomach. Allergic reactions should be reported immediately to a physician to determine whether over-the-counter antihistamines can be used or whether the reaction is severe enough to warrant hospitalization.
Any side effects experienced should resolve within a few days to a week after discontinuing the antibiotic. (You’ll note that I did not mention anything about fluctuating blood pressure. This is because I could not find reference to this as a known side effect.)
Now, to your refusal to take penicillin. Rarely, those allergic to penicillin may also be allergic to the cephalosporin class of antibiotics that cephalexin belongs to; however, this is not always the case.
Stop blaming the antibiotic for your current problems, and start working with your physician to determine what the problem is. Are you on any other medications that may be interacting with your blood-pressure medications? Have you changed your diet or exercise habits? Were you experiencing any abnormal stress just prior to your symptoms? Perhaps you should be under the care of a cardiologist, who can examine and test you for a variety of cardiac conditions that may be the culprit.
I am unclear as to what you mean by an antidote for cephalexin. Stopping the medication should eliminate any side effects experienced, and for those who develop an allergic reaction, antihistamines typically reduce side effects until the drug is excreted from the body. Severe cases may require stronger drugs and hospitalization, but this is rare.

Daily Column

Dr. Gott — Fri, 07 Nov 2008 05:00:06 +0000

DEAR DR. GOTT:
I am 64 years old in good health but take five medications.

About two months ago I got a cold and was given a Z-pack. It didn’t help so I was given Levaquin. Now I cannot smell or taste. How can I bring these senses back?

DEAR READER:
I would first like to comment on your cold treatment. A cold is caused by one of more than 100 different viruses. Antibiotics can only treat bacterial infections and therefore should not be given to individuals with colds or other viral infections.

Now to your senses of smell and taste. Some individuals can experience a loss of these with trivial colds. It can also be the result of various medications. If they have not returned within six months, I recommend you make an appointment with your physician to discuss your meds and what the side effects are. If it is not due to any of your pills, make an appointment with an ear-nose-and-throat physician who can further test you.

Daily Column

Dr. Gott — Thu, 25 Sep 2008 05:00:04 +0000

DEAR DR. GOTT:
I woke up deaf in both ears, after having a hysterectomy. I went to my doctor threes days in a row and begged, pleaded and cried to have a penicillin shot. He kept saying no but eventually caved in. The morning after the shot, my hearing was back to normal. I immediately called and thanked him. A few days later, I received a letter in the mail stating that he could no longer be my doctor because I wouldn’t take his advice and that I should see an ear-nose-and-throat specialist for any future ear problems.

I want to know why doctors no longer give penicillin shots when they work. I was right and it helped my hearing but my doctor made me change to another physician anyway. I am not a doctor, but know that this shot can help many people, has helped many people and works right away on lots of ailments. Please tell my why doctors make us suffer when a simply penicillin shot will cure us right away!

DEAR READER:
You were beyond inappropriate to beg and cry to your doctor for a shot that you did not need. While “divorcing” a patient is a last resort, I have to agree with your doctor in this case. Rather than determining the cause of your hearing loss and taking your doctor’s advice, you behaved in a dangerous and childish way.

Antibiotics, such as penicillin, are over-used and because of individuals such as yourself, drug-resistant bacteria are on the rise. Penicillin is not a cure-all. It should only be used to treat moderate to severe bacterial infections that do not resolve on their own with modest care; this is true for all antibiotics.

As for you claiming to be right, this is debatable. Most people will recover from minor ailments, sometimes even major ones, because they believe something will work. You may have simply believed that the penicillin shot would work so after having it, you recovered. Chances are it was coincidence that your hearing returned after having an inappropriate shot.

Penicillin shots are no longer given for many reasons, but the top two are severe allergic reaction and over-use by individuals who don’t have bacterial infections.

I urge you to control your behavior and listen to your new doctor’s advice. If you disagree with it, you can always seek a second opinion but before insisting on a treatment that may cause more harm than good, you need to know what is causing your problem. Only then can your doctor treat you appropriately. This is true for everyone. While you do not have to take your doctor’s recommendations, it is important that you hear what he or she has to say and find out possible risks from both the illness and treatment.

To give you related information, I am sending you a copy of my Health Report “Ear Infections and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Antibiotics not needed before dental work

Dr. Gott — Tue, 19 Feb 2008 05:00:03 +0000

DEAR DR. GOTT: I am 69 years old and in fairly good health.

Three years ago my doctor prescribed clindamycin to be taken before dental procedures. I have since switched doctors and now my new doctor says this is not necessary. I am willing to discontinue using the antibiotic but am wondering if 1.) use in the past has any harmful effect and 2.) how do I get the dental staff convinced I don’t need it?

DEAR READER: For many years dentists and physicians have been routinely prescribing one or two doses of antibiotics prior to dental work if the patient has heart disease, stents or deformed heart valves. Recent studies have shown that such antibiotic coverage is not particularly useful in helping patients to avoid heart infections, so antibiotic therapy is now only recognized as appropriate in certain instances. Your doctor can advise you in more detail.

You have not been harmed by your previous antibiotic usage and I am certain that your dentist is now aware of the current guidelines. He or she can work with your primary care physician to decide if you need to continue preventive measures or if you truly don’t need the medication anymore.