Antibiotic resistance or malabsorption issues?

Does anyone have any experience and/or knowledge regarding antibiotic usage after RnY?

I have a compromised immune system and I'm not able to fight off common colds very well - typically, I end up with a secondary infection, such as a sinus infection, ear infection or pneumonia.  In the past, my doctor puts me on a round of antibiotics and I've always responded very well to treatment.

Not so fortunate this time!

I had my RnY 10 weeks ago and I'm progressing very well (weight loss is slow, but steady).  About 4 weeks ago I wa**** with a very nasty cold - which was quite unexpected, because I'd already had my "yearly" bout of the common cold.  I just figured that because I was further weakened with the surgery and because I'd been exposed to a ton of germs, so I treated my cold with the usual TLC.

A couple of weeks ago my ear started to ache and then the pain radiated to my jaw.  When I noticed the lymph node on my neck quite swollen, I went to a walk-in clinic and presented my suspicions to the doctor.  He checked my ear and said the ear drum looked clear, but it was obvious I was fighting something, because of the swollen gland. He prescribed Zirthromax (take 2 now, 1 each day for remaining 5 days) and I took them all without fail.

A week later... the ear infection and sore jaw got worse!  The swelling on my jaw and lymph gland were unbearable. I went to the Emerg at the hospital and the doctor said the same thing - ear drum looks clear, but by this time my throat was red and (former) tonsils were swollen.  He said our community "bugs" are quickly becoming antibiotic-resistant and Zithromax just doesn't work as effectively anymore.  He prescribed Cefuroxime Axetil 500mg (2x daily) for me.

Today is day #4 of the treatment and I'm still NOT getting any relief.  In the past I have found antibiotics usually start to work after 2 or 3 days.

I did some googling-around today to see if there's any information out there regarding malabsorption issues with some antibiotics.  I did find a couple of articles about Zithromax not being absorbed well enough (because it passes through the digestive track too quickly), but I'm not having any luck finding info on Cefuroxime.

Has anyone got any experience with this?

I'm nine months out and have found that antibiotics don't seem to work well for me. I required AT LEAST double the dosage (rounds). I have noticed this with both pill and liquid form of antibiotics.  I can tell you I will never take liquid antibiotics again though as 1.) it smells like cat urine and tastes absolutely awful and 2.) my prescription was 10!!! bottles that required a syringe type thing to measure it. It sprays everywhere and required two trips to the pharmacy as they don't normally stock that much. Funny enough, a headache goes away with one dose and so far my vitamin levels are all good. 

My medications normally cost upwards to $50,000 a year so I'm curious what my totals will be after all the additional rounds of antibiotics as it seems I'm always sick with one thing or another. 

Patricia

In the last two months I have been on antibiotics twice. The first time for an infected cut on my leg. Original antibiotics given me in the Caribbean were the right type but not strong enough. when i came home was given the Rx again and the infection cleared up. recently I had an abdominal abscess. I am on strong antibiotics they cultured for the specific infection I had. They are working wonders.  I still have some left but the fever and infection is going.

Since you go on antibiotics regularly you may be becoming resistant. I would suggest you have the infection cultured. They can then give you the drug that is specific for the infection you have.

I am almost 15 months out.

No, I'm not on antibiotics regularly.  So, I don't think it's ME that's resistant.

The only thing that's consistent about ME, is when I get a cold (once per year) I usually get a secondary infection - and I get an antibiotic for that.

Sorry misunderstood your comment about being on antibiotics with a weaken immune system. I would still have the infection cultured. Most doctors today agree this is the best way to get the drugs that work for your symptoms.

good luck

I hear ya!  Unfortunately, with an inner ear infection there's no "external" discharge to be captured to send for a culture.  It's a "best guess" situation for them to prescribe an effective antibiotic.

Do you have a family physician?

Going to a walk-in clinic and then into Emerg, you dealt with on-the-spot diagnoses ... when what you really need is a proper work-up.

It is entirely possible that you have been prescribed antibiotics for a viral infection. Obviously, they would not work in that case.

It is also possible that you have been the victim of an antibiotic-resistant bug - there are now many, and they can be nasty.

Ask your GP (or failing that the Internist on the bariatric clinic team) to perform an NP (or Nasopharyngeal) swab.

Flailing around guessing at this is not going to get this properly treated.

Malabsorption may be an issue - but the internist at your Bariatric clinic would know for sure. Take this seriously, is my advice.

I've had issues a few times since my RNY which I think are due to malabsorption. The last time I asked for liquid antibiotics and those did the trick.

Linda

Why yes, I do.

I was just about to write a post of my own experience.   How timely -- and how good that others have responded to you so well.

I've had a cold/chest congestion/runny nose (productive cough...i.e. (ick) green) for 15 days now.    A week ago today I went to the after hours clinic that covers for my family physician as he was away for the week.   I was coughing heavily the whole time (still am).  I arrived with my always present list of current medications and provided the necessary information on my recent (January 23) RNY.   It took the doc a few minutes of looking to come up with _Avelox_ as a med that wouldn't negatively interact with my current meds (pretty standard stuff).

A week later and I am no better.  

I did the call in at 8:30 thing this morning, to my family physician, and all his spots for today were filled. I said "please please" and they checked with him and got me in tomorrow. I can live with that.  

CostCo pharmacy did their research, called me back this a.m. -- if it's viral (bronchitis), you know the drill (hydrate, rest, possible bronchial dilator ... cough drops/syrup)  

Received a long, detailed voice mail in response to my call to the Weight Management Clinic Nurse Practitioner (I *love* her--Aspen by name) -- the reassurance that antibiotics are not normally an issue for malabsorption ... I can take that to my family doc tomorrow.  

So ... nose running, still coughing heavily, sinus pain and no energy to speak of. Had my hair cut this afternoon and am pretty well knackered.   I'm keeping hydrated and am relieved with the answers I've had so far.   I guess it makes sense that this would bring me low, considering I'm taking in only about 700 calories a day, although keeping my protein high.  

And .. for what it's worth -- I am sleeping well, and not coughing -- thanks to my CPAP machine, I'm not suffering from lack of sleep, at least.  Very strange, eh?  

And now, I'm tired ... going to bed.  :) 

I don't know if this helps -- hope it does.  :)  

mmm

Many of the antibiotics you list are available as a timed-released, sustained-release or extended-release formula which are no good post-bariatric surgery. You need antibiotics that are immediate release. You can usually get the same drug in either formulation. The difference is that regular release antibiotics usually have to be taken 2-4 times per day and the newer, extended-release ones are just 1-2 times per day. Docs always prescribe the extended-release ones these days as it is easier for people to remember to take pills less frequently. You will have to insist on regular release formulations for your antibiotics and simply remember to take them more frequently, or they will not be effective. There is no other reason for antibiotics being less effective or requiring a higher dose post-op.

Hope this is helpful.