Antibiotic Side Effects & Duration: What You Need to Know

Question
QUESTION: ""Priority:HIGH ~Please Read and answer carefully...

Dearest DR Borucki:

An allergist once told me that she thought I had allergic rhinitis. I have had occasional Sinusitis in my entire life it has been treated with antibiotics twice.I have a 1cm hole in my septum I believe was due to drug use over 20 years ago.No structural damage. Age 56. I have been drug free since 1985...

These are the primary symptoms:

~nasal congestion!!!!

~"quite minor" Sinus pressure/facial pain(details below)

~Decreased sense of smell or taste!!!

~"some"Fatigue/Irritability!!

I'm in good health and on paper will live to be 100 they tell me. My immune system has been in good shape overall. I eat quite well and exercise and sleep about 6 hours a night.


Question: Since about the first of September I have had various amounts of discolored mucous [mostly bright/darker yellowish and some lighter gray]that I mostly have to snuff in first and then spit out. Only after a Nasal rinse may I actually be able to blow my nose and get any mucous. I have had slight headaches here and there with no temperature,very minor coughing if any due to the flem running down the back of the throat I presume?!? no fever or chills. I had only one bout of sneezing three nights ago that I thought was never going to stop. Nothing since... Just a really annoying stuffy feeling along with some spaciness and the symptoms listed above... I NEED YOUR HELP !!!!

I'm wondering if this in "fact" is a sinus infection viral/bacterial? Allergies? Cold? Whatever the heck ?!? It is wearing me out..


WHAT IS THE BEST WAYS TO DETERMINE[DETERMINE] AND TREAT[TREAT] THIS CONDITION(S)? Would antibiotics be useful at this time?

I should also mention I use Claritin as needed and Nasonex 1 spray each nostril twice a day about a half hour after I do the nasal rinses.



Thank You for your care and attention to this vital condition that has not responded to what I would say were reasonable treatment measures...

Hope and Pray your doing well and can also give me useful/practical advice about this so that I can enjoy life again.HONESTLY! I do not know what to do?!?!?

Sincerely Ralph""

PS: I'm resnding this as I have seen NO IMPROVEMENT!!! And I have not HEARD FROM YOU....

ANSWER: I think I just answered this one....

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QUESTION:  I NEED YOUR HELP!!!
Thanks so very much!!! I tolerate Keflex well. PLEEZE give your best advice/choice to treat this condition?!?!?! Do you ever use zthromycin and whats your opinion of it?!? I have a very sensitive system and have side-effects. So I tend to stay with Meds that I know I can tolerate...
PLEEZE get back to me ASAP...suffering and weary. I live in a very rural area with quality care at an absolute premium.
Sincerely Ralph

ANSWER: keflex and zithromax, may not cover the bugs in the sinus'  Ceftin isn't that high priced, nor ix Biaxin.  Augmentin, Levaquin and others get expensive.

---------- FOLLOW-UP ----------

QUESTION: Dear DR Borucki:

I have  two question pertaining to the use of antibiotics.

If  antibiotics are prescribed for a "marginal" condition that may not even require them.Such as a "possible" sinus infection. That has not been tested and proven to be Bacterial at it's source. Yet after taking the antibiotics for about 3-5 days instead of the recommended 10-14 day coarse. And the condition being treated has totally resolved . What is wrong with stopping them rather than suffering with the presumed side-effects like diarrhea,dizziness,fatigue,headache etc...

Also,how soon "typically" do these side-effects develop such as diarrhea after starting the antibiotics?!? Is it hours days a week ?

Thank You,
Sincerely.RF

Answer
It is rare to get diarrhea after one dose... it usually is a few days of the antibiotic.... and almost always, it resolves when you stop the antibiotic.  

The problem with stopping early, is, you may have suppressed the infection but not cured it, and if there is a bacterial mutation to be resistant to the antibiotic, and that strain has a resurgence in your sinus', then you will have a resistant strain growing that won't respond to a repeat course of the antibiotics.

The antiobiotics should be taken until completion for complete eradication of the bugs....