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Antibiotics - When the Super Drugs Fail to Deliver

Antibiotics - When the Super Drugs Fail to Deliver

In the medical community, infection and antibiotics are logical companions. Over centuries as antibiotics developed into more sophisticated and targeted treatment options, many diseases that formerly killed people were cured.  As with any drug, there is the good side and the bad side.


Antibiotics: Common Treatment for BV


Antibiotics are intended to be heavy weapons in the war against bacteria. With Bacterial Vaginosis, the potential is high that antibiotics become “friendly fire,” killing off more of the good bacteria than the bad bacteria.


Generally speaking, the good bacteria are not as powerful as the bad bacteria so they are early causalities in the antibiotic assault.


The good bacteria have no chance to repopulate the vaginal environment when harmful bacteria make the conditions hostile territory.


A major problem that frustrates physicians is that too many patients finish taking all the antibiotics in the prescription bottle.


Even with the added instructions on the label plus the information sheet provided by the pharmacy, women don’t read these important instructions.


What tends to happen is that after a week, a woman feels better and notices less discharge or odor problems, so she pronounces herself “cured” and tosses away the drugs. While it may seem silly to continue taking medication after feeling better, it’s absolutely necessary.


Which Is Better - Oral or Vaginal Antibiotics?


Prescription antibiotics are delivered in either oral or vaginal medications. The question of better or worse is difficult to answer since what is better is the antibiotic that works fastest with the least negative side effects. Unfortunately, the only way to find this out is to use the medication.


The vaginal medications are in gel, cream or suppository form. While these can be messy, the advantage of vaginal medications is that there is less likelihood of experiencing the side effects, which can occur with oral medications.


Even though a woman may prefer to use the cream or gel prescription, those are not acceptable choices when pregnant or attempting to get pregnant. Vaginal medications are not considered safe for use by pregnant women because these medications are inserted directly into the vaginal canal.


Oral medications are easier to take and some antibiotics are only available in the pill form such as Flagyl, Tinidazole and Tindamax. Cleocin and Metronidazole can be prescribed in either oral or vaginal medication forms.


The oral medications can be more precise in dealing with systemic infection; however, they come with some unpleasant side effects such as:


·         Nausea

·         Vomiting

·         Diarrhea

·         Loss of appetite

·         Headache

·         External rash

·         Oral thrush (internal rash)

·         Metallic after-taste

·         Burning sensation similar to acid reflux

·         Vaginal yeast infection


When taking some oral medications, the nausea and vomiting can become severe if any alcohol is consumed. Even small amounts of alcohol such as in over-the-counter medications can prompt these reactions.    


Some side effects signal a serious medical complication that needs immediate attention. The prescription information sheet provided by the pharmacy tells which side effects are the most severe.


If the diarrhea does not stop, the woman is losing life preserving electrolytes that cannot continue to be depleted.  Blood in the stool or severe cramps that are more intense than the menstrual cramping are cause to seek medical treatment.


How Effective Is an Antibiotic Treatment for BV?


Physicians use the term “a course of antibiotics” such as for 14 or 21 days.


This time period is based on research, which indicates the average length of time needed for the antibiotics to fully wipe out the bad bacteria.


To stop short of this time is to invite the bad bacteria to keep the party going. 


The disappointment is that after dealing with side effects from oral medications or messy vaginal creams and gels, the success rate from these treatments ranges from 50%-90% according to the CDC’s 2002 guidelines.


After all that effort and surviving side effects, a woman hopes for something more certain to take away the aggravation of living with BV. The anticipation of getting help quickly for BV is not always met with the success level that expected.


Failure to complete a course of antibiotics several times and the bad bacteria literally grow stronger and more immune to the medication the next time. Completing all the pills in the bottle, whether you think you need it or not, is crucial.


If the drug causes side effects that are uncomfortable, contact the physicians and let him or her decide how to transition to another drug. Unless there is a medical degree on your wall, don’t make this decision for yourself.


The Downside of Antibiotics


Americans are a pill-oriented society. We want to deal with any medical problem with a pill and preferable a fast-acting pill. Unfortunately, the same antibiotics that can eliminate BV can also cause a reoccurrence of BV. Yes, that sounds bizarre, but it’s a bacterial reality.


Women who fail to complete all the antibiotics in the pill bottle or use all the cream/gel are making it easier for BV to return. Even if you are tired of bothering with the medication because you feel better, you can’t stop the medication too soon.


Antibiotics are like the invasion force landing on the beach to push back enemy forces (the bad bacteria).  That’s why you can start to feel better in a few days and get a false sense of security that all is well. However, plenty of the bad bacteria escaped the first assault of medication and is ready to stir up the symptoms again. 


Continuing to take the antibiotics until completion gives the medication time to destroy all the bad bacteria. That sounds like good news but there’s a bit of bad news along with it


Antibiotics Set Up New Problems


Use of heavy antibiotics or repeated use of these drugs sets up more problems than just those in the vaginal environment.  Repeated use of antibiotics for any medical problem becomes a new problem in itself.


What the physician rarely tells a woman is how to offset these problems. When taking antibiotics, drink Lacto-bacillus milk or eat yogurt with Probiotics If you don’t like milk or yogurt, probiotic supplements are available in capsule form from a health food store.


Research has shown that frequent use of antibiotics for childhood ear infections leads to development of more ear problems. The same situation can occur for adults as well.


When women take several courses of antibiotics, they are at higher risk for earaches and sinusitis.


Once that happens, they go to the general practice physician who promptly prescribes more antibiotics and the cycle of symptoms continues.


Women must not be lulled into thinking that an antibiotic for BV only impacts the vaginal area. Once in the system, an antibiotic can affect any part of the body.


While taking antibiotics you can expect to have bad breath. That happens because the good bacteria in the intestinal tract have been diminished so the digestive process is not working efficiently. That bad breath is an early warning that the antibiotics have meddled with the balance in the intestinal tract.


Even if there is no bad breath or grumbling stomach, always pay attention to replenish the good bacteria that is diminished by the antibiotics. This will help to avoid repeat occurrence of BV or a new yeast infection.


It will also help your digestive system to function better and to avoid constipation from poorly processed foods that back up into the system.


Bacteria Learn Fast


Bacteria are smart and they learn fast. BV has a remarkable ability to become resistant to antibiotics after the second or third time of treatment. For some women, that resistance can build up after just one course of treatment.


When the antibiotic medication is no longer effective in eliminating BV, another antibiotic is substituted in its place. The problem is, these antibiotics are all chemically similar is purpose so it gets harder and harder to find one that works after several BV treatments.


Not only are the antibiotics less able to fight back the BV after several treatments, but some women found that the side effects are more dramatic and long lasting.  


It becomes a toss-up as to which is worse; constant nausea and headaches or BV smelly discharge and itching.  Women in this situation don’t know where to turn for help, particularly after taking medication faithfully and still having these unpleasant side effects.


How can you know if your body is drug resistant to BV antibiotics? Your treatment will follow a course like this:


·         Physician makes the BV diagnosis and prescribes an antibiotic

·         Patient informs the physician if she has any prior negative experiences with any antibiotics

·         Start taking prescription antibiotics for BV

·         Within 4-7 days, patient feels relief from the antibiotic medication and gains a sense of hope that the BV can be cured

·         Within the same 4-7 days, patient experiences side effects that are mild to severe

·         Patient reports side effects to physician

·         If side effects are severe, an alternative antibiotic is prescribed

·         The patient may have to go off the antibiotic early in order to get the severe side effects under management

·         Or the patient fails to report side effects to the physician and decides to stop taking the drug


·         The toughest bacteria take the longest to eradicate so stopping or changing medications create conditions in which the bad bacteria thrive while the good bacteria have little chance to take back control of the vaginal environment


Each time this cycle is played out, the bad bacteria learn how to evade the antibiotic or basically ignore it. You might say that the bad bacteria “eat the antibiotic for lunch” when they overtake any positive result.


This sets up the conditions for a repeat of BV, which is strongest and now more drug resistant than before.


Over-the-Counter Medications


Ok, if prescription medications are not a sure cure and cost more money (plus the cost of the doctor’s appointment), then are over-the-counter medications just as effective? 


After all, it’s easier to drop into the discount retailer, supermarket or 24-hour pharmacy and grab a tube of medication on the way home.


Do some comparison shopping and discover that the over-the-counter medications are neither cheap nor highly effective for serious bout of BV. These medications are mostly anti-fungal, which can work for a yeast infection, but BV is not the same problem.


There might be less expensive over-the-counter medications available on the Internet, but you need relief now, not five days later after the package reaches your mailbox.


Purchasing online means that you have to do the product research because there’s no pharmacist to consult.


Over-the-counter medications are not going to be as powerful as prescription antibiotics so you could spend more and suffer longer waiting for the cheaper treatment to work.


The local pharmacy is a better option than buying from the supermarket or discount retailer as there is a pharmacist to ask for advice in choosing a product.


Don’t be misled by the advertisements touting the strength and effectiveness of over-the-counter creams or gels. The pharmacist will confirm, these over-the-counter medications are generalized and not targeted the way that prescription antibiotics are toward specific types of bacteria.


Because there is no way to monitor the use of over-the-counter medications, the potency is not as high as what can be given in a prescription medication from a physician of health clinic.


On the other hand, an over-the-counter cream or gel may be better than nothing late on Saturday night when you simply can’t stand the BV symptoms another minute. 


Any help is worthwhile, just realize that over-the-counter medications only offer a temporary relief from symptom but they lack the potential to cure a serious BV outbreak.

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