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Safest antibiotic long-term?


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#1 Chaos Theory

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Posted 27 October 2010 - 05:00 PM


I've been having recurring skin infections for over a year now. It's folliculitis on my face where I shave. I've tried nearly everything OTC, as well as countless prescriptions including retinoids and clindamycin. The only thing that has consistently gotten rid of it completely is a course of oral antibiotics.

Bactrim cleared it right up but that is definitely unsafe for long-term use.

Keflex worked also, but took longer. I used it for months with no major issues or apparent bacterial resistance.

I just began using doxycycline and after only a few days the infection seems to be subsiding again. As far as side effects, thus far doxycycline seems to have the least, though sun isn't an issue this time of year.

I don't like the idea of being on antibiotics indefinitely but many doctors prescribe them in situations like these, and I feel I'm officially out of options short of trying accutane. I use probiotics 1-2x daily, jarrow brand at the moment but I'm open to others if anyone has a suggestion.

What is the "safest" antibiotic for me to take? My GP mentioned azithromycin which can be taken for a few days in a row and then not taken at all for over a week. I'm leaning towards this option as it seems like it would be the least harmful to intestinal flora and there is evidence supporting azithromycin used in this way because it highly concentrates in tissues.

#2 FunkOdyssey

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Posted 27 October 2010 - 05:06 PM

Doxycycline would be my vote. I'd suggest shaving with an electric razor too, that tends to prevent this sort of trouble (most of these problems result from cutting hair too closely).
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#3 nameless

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Posted 27 October 2010 - 05:54 PM

Doxy would get my vote too. And Azithromycin may be even less stomach-friendly than Doxy is.

I've found that a Mach 3 power + Aveeno shaving gel alleviated my shaving problems, but your case sounds like it is worse. The other alternative, of course, is just grow a beard.

#4 Chaos Theory

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Posted 28 October 2010 - 04:26 PM

Do you guys have a specific reason for suggesting doxy over azithromycin? Is there a side effect of azithromycin I'm not taking into account or is it just more broad spectrum?

I have a few concerns with doxycycline, one being the sun sensitization during the spring and summer. What concerns me even more is potentially permanent skin thinning associated with it. I'm not sure how rare the latter is, but it's listed as a side effect.

As far as shaving methods go, I tried them all before I started the oral antibiotics. Different types of electric shavers, old-school safety razors, multi-blades, different shave creams and soaps.. Finally I settled on using "bump fighter" razors which are marketed to black men (though I'm not actually black). The blade is recessed in the shaver so it is impossible to cut the skin. I think I'm just out of luck in this department as it only takes the minor abuse of shaving to compromise the follicle and allow infection.

#5 FunkOdyssey

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Posted 28 October 2010 - 04:49 PM

Azithromycin is harder on the gut flora, that's the main problem in my opinion. I think sun sensitization concerns with doxycycline are generally overblown, particularly at low dosages. I was taking 400mg daily and was out in the sun during the summer with no trouble.

Permanent skin thinning... I've never even heard of it. It's so widely prescribed for acne for very long periods of time. Incidence rate must be very, very low.

#6 tlm884

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Posted 29 October 2010 - 02:36 AM

I've been having recurring skin infections for over a year now. It's folliculitis on my face where I shave. I've tried nearly everything OTC, as well as countless prescriptions including retinoids and clindamycin. The only thing that has consistently gotten rid of it completely is a course of oral antibiotics.

Bactrim cleared it right up but that is definitely unsafe for long-term use.

Keflex worked also, but took longer. I used it for months with no major issues or apparent bacterial resistance.

I just began using doxycycline and after only a few days the infection seems to be subsiding again. As far as side effects, thus far doxycycline seems to have the least, though sun isn't an issue this time of year.

I don't like the idea of being on antibiotics indefinitely but many doctors prescribe them in situations like these, and I feel I'm officially out of options short of trying accutane. I use probiotics 1-2x daily, jarrow brand at the moment but I'm open to others if anyone has a suggestion.

What is the "safest" antibiotic for me to take? My GP mentioned azithromycin which can be taken for a few days in a row and then not taken at all for over a week. I'm leaning towards this option as it seems like it would be the least harmful to intestinal flora and there is evidence supporting azithromycin used in this way because it highly concentrates in tissues.




I would personally suggest Keflex again. I have tried both Keflex and doxy for acne. The doxy worked much faster but it was VERY hard on my intestinal flora.

#7 Rational Madman

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Posted 29 October 2010 - 09:20 AM

I would say Doxycycline and Minocycline, which also happen to offer some pretty impressive cognitive benefits, and in general, are excellent broad spectrum antibiotics.
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#8 maxwatt

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Posted 29 October 2010 - 01:24 PM

Have you seen a dermatologist? Oral anti-biotic for a skin infection, particularly folliculitis, sounds like overkill, at least as a first-line treatment. Combination fungicide-antibiotic ointment or lotion could be equally effective. And sterilize your shaving equipment before use, use an astringent aftershave.

I had folliculitis on my stomach, and neither antibiotic nor fungicide alone cleared it up, needed a combination. The first dermatologist I saw started with topical antibiotic, was going to try oral when that did not work, found another opinion for using toical fungicide/antibiotic.

#9 Matt

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Posted 29 October 2010 - 04:39 PM

Trimethoprim ALONE, it's safer because you're not taking the sulfa. Many people use trimethropim for months or years for chronic infections, like UTI's. Doxy is also pretty safe, but I would try trim first.

Edited by Matt, 29 October 2010 - 05:09 PM.


#10 Lufega

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Posted 29 October 2010 - 09:43 PM

Apply a thin layer of coconut oil on your skin under the shaving cream. Then use the razor. Repeat this with every pass. It'll prevent the razor from cutting the skin too close and it's also antibacterial. On the other hand, you could try an allicin supplement like Allimax to combat the bacterial infection.

#11 adamh

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Posted 01 November 2010 - 09:16 PM

I had foliculitis years ago. What I found worked was topical antibiotics, the type you can get otc. The sores kept coming back and what seemed to get rid of it was when I quit eating sugar and flour based foods. I did it to lose weight but after a period of time it got rid of the foliculitis too.

It's a great diet for general health, no gluten, very little fructose and other simple sugars. But it's such a radical diet that hardly anyone will try it or stay on it. After a few weeks you get used to it. It helps if you eat a lot of veggies already.

#12 xEva

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Posted 02 November 2010 - 07:19 AM

I agree with adamh that keeping your blood glucose low will help starve the intruders. As for azithromycin, the reason you can take it more seldom is because it stays in the body longer. Its half-life is 68 hours. Compare with 18h half-life of doxi. Also, you should keep your skin pH around 5.5. Check the pH of the things you put on your skin: soaps, creams etc. They should not be alkaline (all soaps are) or adversely affect the pH of your skin. When it is in the right range, it has natural resistance to infections. If you have nothing else, putting on some plain yogurt or kefir in place of a lotion can help with pH.

Edited by xEva, 02 November 2010 - 07:20 AM.


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#13 eon

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Posted 31 January 2015 - 02:07 AM

I've read about Minocycline being used for acne and experimentally for Schizophrenia year round so it's good for long term.

 

What length of time is considered a "full course" of antibiotic?
 
I'm sure it varies but there had to be a general guide as to what the minimum is and what the maximum is. Does anyone know? Is it take as needed? If you feel it's working stay on it, if it's making you feel weird, get off it?
 
I'm trying to treat what I think I have (toxoplasmosis, Lyme disease), and even if I don't have these, Minocycline is considered neuroprotective and antioxidant. Experimentally, this could ease my depression (winter blues) and or what my original diagnosis is: psychotic disorder. Although I'm highly functional without meds and without the depressive symptoms I once had. I'd still like to try this wonderful antibiotic just to see how I respond to it.

Edited by eon, 31 January 2015 - 02:16 AM.





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