Medical Jellies: has Amoxicillin fallen out of favor for treatment of bronchial infections?

I’m thinking your probably take Amoxicillin Clauvanate? If so, patients and doctors tend to prescribe other drugs that don’t destroy the normal flora in the intestines and vagina as much. Also, amox clauv is minimum twice a day, Amox alone is three times a day, while other drugs are once a day. Amox and Amox Clauv also tends to be irritating to the stomach of many people. It also is a 7–10 day reigimen, while other drugs are 5. Patients are more compliant when a drug is easier to take for a shorter time period. In addition I would guess the new drugs are promoted more heavily by the pharm companies to doctors.

Amoxicillin Clauvanate is my wonder drug for my GYN problems. The only drug that gives me magical relief. When I have a bacterial sinus infection I still take it, because it is so good for the rest of my body, but I request it.

I think big pharma probably plays a role. They don’t pay those pharmaceutical reps so much money just to look cute and drop off samples at doctors offices. Their job is to convince doctors that their expensive drugs are way better than the inexpensive drugs that have been around for years.

@JL

I’m referring to plain old Amox. typically either 250mg. 4xper day or 500mg 3xper day for 7–10 days. My long time Doc in Philly typically started out at 250mg and upped it to double if necessary.

Amox Clav also goes by the name Augmentin and IS VERY expensive. It’s a really broad spectrum and the only time it was necessary was when I got bitten by a cat. Her too hit one of the bones in my finger.

I asked the Doc if there were a less expensive alternative and there just plain wasn’t. I had done enough reading up domestic animal bites to know that there are some uncommon pathogens found in their bites. So I just bit the bullet since I wasn’t in the mood to risk losing a finger, hand or arm to a virulent infection.

But that was a unique situation and it hasn’t been necessary since.

Quite frankly, for normal situations, I think $5.00 per pill to be excessive when there are at least a dozen or more reasonably priced drugs which have stood the test of time for proven efficacy as well as for me in particular.

My son was uninsured and on a med that cost $1000 a month. It’s criminal.

@Judi EDIT: (referring to your first post since I had not read the second while posting this)

My thoughts exactly.

I just chose to withhold expressing that to the Dr. figuring why antagonize someone needlessly.

But if I’m wrong about that and others have more updated info on the state of Amox I’m certainly not adverse to learning a thing or two.

Wow. That’s unconscionable.

And I thought I had problems :)

Wow, just wow.

Were you able to get any relief from the company who makes the drug? Some of them do have special programs for their own brands.

Or how, about Canada? Tons of Seniors do it regularly.

I finally did get him on the prescription assistance program, and 3 years later he got on disability. He seems to be recovering and has held down a job for more than 6 months. This job has insurance so I’m not as worried this week.

Oh I’m so relieved and happy to hear that.

Ok, plain old amox is three times a day I think, and people sometimes take it 3 times during waking hours, instead of every 8 hours, which leaves room for it not to work. Probably there has been some resistance built up to Amox I am guessing, since the doctors seem to be prescibing in larger doses. Augmentin (I did not write the brand name because so often when I do people say, “no I am taking amoxicillin,” and then I say Amox or amox Clauvanate, and many times it winds up being the latter, because it is available generic. Available generic except for Augmentin XR, which also means to me maybe these bacterias are needing a more powerful punch, since the dose is so high.

I’ll send the Q to rarebear, I’m sure he prescribes for this sort of thing all the time.

Oh, and I think of pneumonia as being treated with Levaquin (assuming it is bacterial pneumonia) and probably severe bronchitis also. Regular bacterial bronchial infection that starts in the sinus I would ask for Augmentin. So rare for me to get a bronchial infection I don’t get prescribed for it often; maybe I need a drug for that once every 7–10 years, so I am working off of old knowledge, and I am not a medical professional.

I’m allergic to amoxicillin. Last time it was prescribed to me it turned my entire body from the neck down a deep dark purple color. Maybe other drugs have less risk of reactions?

Actually for bronchitis, no antibiotics are indicated. Antibiotics are only indicated for COPD exacerbations and pneumonia.

@Adirondackwannabe Amoxicillin is a Penicillin, are you allergic to ther penicillins? I wouldn’t say it carries more risk of allegy, it just depends what you happen to be allergic to. The one antibiotic that probably over 50% of the population is allergic to (I made up that stat, but truly a lot of people are allergic to it) is sulfa drugs.

@Rarebear But, sometimes it starts in the sinus and then goes into the chest, if it persists over a week, isn’t a typical cold, with a severe cough, wouldn’t you assume it is bacterial?

@JLeslie My brother is very allergic to penicillin. He goes into anaylphalatic shock. That was the first time I turned purple.

@JLeslie Even if it is a bacterial bronchitis, antibiotics only shorten the symptoms about a day, and you increase the risk of developing resistance. If you like, when I get home, I’ll be happy to provide references.

@Rarebear

I do understand that unnecessary antibiotic prescribing for virally caused things does zero good and potential harm from overuse. But this changed from a rather typical cold, stuffy nose etc. Lodging deep in the chest with me hacking up gobs of greenish brownish mucus. Pardon the graphic description but all my previous Drs. have told me thats the turning point between a simple cold and a worsening secondary infection, usually bacterial (at least in my case.

Not lately, but in previous years ive gone through bouts of round robin continuing sinus, bronchial infection. One gets cleared up and a few weeks later another one.

I was originally going to wait till Mon. for regular hrs. but when the shoulder blade pain was continuous, I realized it could be more serious. They did chest Xrays. and told me that there was a pocket of fluid in my lower right lung. Not pervasive yet but the beginning of pneumonia.

I didn’t realize till after I left that the prescription was for one of these ridiculously expensive ones. I know that there are at the least, a half dozen or more affordable generics with a proven longstanding record of efficacy for bronchial infections and pneumonia.

So I called back and two hours later finally got to speak to a Doc. Since regular Amoxicillin had repeatedly worked for me, over MANY years (20 plus) was there any reason she couldn’t call that in to my regular pharmacy instead.

Of course she didn’t give me a straight answer and informed me that Amoxicillin was not a good choice for pneumonia. Well, thats news to me. First time ive ever heard that. As a matter of fact, two years ago thats precisely what my regular DR. prescribed. His idea, not my request.

Hence my Q. Whats changed, if anything, in the last two years. If there is something significantly changed regarding Amoxicillin. efficacy, I’m open to New info.

But if she was simply glibly defending her relationship with the perks provided by the manufacturer of said super expensive drug, then she wont be seeing my face ever again, thats for sure (not that I’m frequenting Urgent care places all that often. Last time was over 10 yrs. ago)

@Rarebear Not necessary. :)

I thought I’d get a few points for turning purple.

@Adirondackwannabe I gave you one. Don’t forget that now you might be developing an allergy to that class of drugs, penicillin, and some people who are allergic to penicillin are also allergic to cephlasporins. But, it doesn’t have to mean that is the case, it couldbe some inert ingredient in the amox that gave you a reaction, and the penicillin might have nothing to do with it. Just next time you are prescribed penicillin don’t take the first pill alone, and maybe have a epipen nearby. Always good to have one in the house anyway, you never know when so eone woll have an allergic reaction. My husband thought he was allergic to penicillin, and then at one point it was the best drug for him to take, and the doctor decided he should give it a try. He was totally fine, his mom had probably comfused a penicillin with some other antibiotic when he was a kid. We have no idea what he might have had a reaction to.

@Rarebear: ”Not lately, but in previous years ive gone through bouts of round robin continuing sinus, bronchial infection. One gets cleared up and a few weeks later another one.” — Have these previous recurrences happened after taking Amoxicillin? If that’s the case, a stronger antibiotic may be more effective.

As for ‘perks’ from pharmaceuticals companies, they’ve cut most of those. We don’t get pens or post-it notes anymore. We barely even get any samples of the medications. Just the occasional lunch while the rep gives their presentation.

@Adirondackwannabe: At the age of 19 I broke out in hives from amoxicillin. From scalp to toes—it was a miserable experience.

@JLeslie I’ll keep that in mind, thanks.
@hearkat I was purple from the neck down. I should have gone swimming. It wasn’t uncomfortable, just funny looking.

@hearkat I think you’re tagging me incorrectly. That wasn’t my quote.
As for free pens and lunches… Sign the pledge
http://nofreelunch.org/

@Rarebear I do have a question about the studies afterall, no need to search for a link if you know the answer off the top of your head. The studies were done starting antibiotics day 8+ of the illness? The studies that start meds in the first 6 days of an illness don’t interest me, because I think people should gauge first if it is viral and if the body is fighting it on its own even if it might be bacterial. But, a typical cold is 7 days. Flu is very bad thru day 4 or 5, and then typically although still sick the patient knows they are getting better. Bacterial infections that persist with some or a lot of sinus involvement, bad coughing jags, with no sign of healing by day 8 typically nedd an antibioic in my opinion, and I have a hard time believing in that situation people get better with just a day’s difference on meds or off, because I think that sort of situation is almost always bacterial, and by day 8 or 9 the patient has proven they are not fighting it well.

I’m out of town again so it’ll take me awhile to dig the data up. The studies were only for acute bronchitis. Sinusitis is still treated with antibiotics and flu is treated with Tamiflu if caught within 72 hours.

Remind me in a week and I’ll get the data. I’ll try to get it before then but I only brought my iPad with me and I don’t have access to my hospital database.

Here is one I was able to link from while sitting in the airport lobby.
http://www.nejm.org/doi/full/10.1056/NEJMcp061493

There are others, but you get the point.

@Rarebear Thanks. Don’t worry about digging around for studies. I appreciate the effort. I see know I am talking about something different.

I did recently see studies that showed treating ear infection with antibiotics was significantly more effective, after years of some trying to push for not treating.

Well, apparently SOME Drs. don’t view Amox as a first line drug for pneumonia anymore.

But, my previous Dr. in Philly almost always started out with it FOR ME since it almost always got the job done for over ten years of both deep bronchial infections as well as pneumonia (have zero idea what he did with other patients)

That’s why I found the statement of the UC Doc a bit strange but apparently the Family practice guy I later went to when the Tetracycline wasnt making a dent, also shares that opinion. Who knew?

I haven’t been this sick in well over 12+ years, and I naturally figured that what worked for the last time I had Pheumonia, would still work. I have no idea why thinking on Amox seems to have changed a bit over the last 10 years + or what prompted that.

But what I do know for certain is that it does not require $100.00 or more to find an antibiotic sufficient for the task.

Bactrim, Cipro (and probably a dozen others @Rarebear could name) clear up early stage Pneumonia equally well.

Of course Big Pharma would love it if every Dr. routinely used the super-duper expensive ones. But it’s those damn pesky educated consumers (and other Docs) who keep throwing a monkey wrench into the works :)

So, time to throw more advertising money at the situation to overcome all this nonsense about sensibly priced generics.

So, long story short, Bactrim seems to be getting the job done currently. Not as quickly as I’d like, but….

Not sure on the data on ear infections. I’d have to look it up too.

@Rarebear: Sorry about the faux-pas… I guess it happens when a prodigal Jelly returns, I’m like a newbie all over again!