Preventing a flare when going on antibiotics?

[cdrisc]

Hello all!

I've had chronic sinus infections for the past couple years (well, much of my life but the past two years have been unmanageable without antibiotics). I've seen an ENT and had a CT scan; I have significant inflammation and my sinuses drain poorly, so I have a surgery scheduled early November.

I've been on a 3-week course of antibiotics with the one antibiotic that doesn't seem to make my MC flare (Bactrim). Unfortunately, it hasn't worked well enough to clear the infection and I'm faced with going on a new one: doxycycline. I've been on it in the past, and it caused a flare last time after a week (albeit, not as bad as broad-spectrum antibiotics). I can only assume that it will cause an issue again. I've thought of going on budesonide immediately when I start the antibiotic to prevent or lessen any impending flare.

Any thoughts on this course of action? Does it hold up to logic? Any differing opinions? As always, I welcome the debate and your collective wisdom.

- Chris

P.S.

A few more thoughts/comments on my situation:

My sinusitis is exacerbated by allergies, but the formation of my sinuses are really the kicker here. This forum has a lot of good information on antihistamines/mast cell involvement in MC. I now take allegra regularly; I think it helped me out of a flare (I can't be entirely certain - see next comment). It helps with my allergies better than my old standby, zyrtec. Alas, it's still not enough to keep the infections at bay.

I was on Bactrim during the time-frame that I went into remission. It's the second time I've been on it this year, and also the second time that I have went into remission while on it. I wonder if some bacteria has made its way into my colon, exacerbating the MC. And even if this hasn't happened, I know in my gut (pun intended) that there is some connection between the MC and the sinus infections. They often occur simultaneously. Was remission due to the allegra? the bactrim? Too many variables to get a definitive answer.

Although I loathe the idea of sinus surgery, I've known some folks that have had good success with it. What tipped me over, though, was when my doc mentioned that she could effectively treat me with inhaled antibiotics after the surgery, since my sinuses will be open. I hope to never need an antibiotic again, but it's good to know that I will have this option before having to take an oral antibiotic.

[tex]

Hi Chris,

I see no one has "tackled" your post, so I'll give it a try. Doxycycline is definitely responsible for causing more than a few cases of MC, and it will probably cause diarrhea while you are taking it. But that doesn't mean that it will cause a relapse of MC. Possibly the biggest influence for causing relapses in such a situation may be the physical and mental stress of the surgery itself and the recovery period. If you can hold the stress levels down, even if the antibiotic causes diarrhea, you might be able to keep it from causing a persistent relapse that lasts far beyond the use period of the antibiotic. Just thinking about how much better your life will be after the surgery, for example, should help to hold down stressful thoughts.

Also note that a few authorities feel that antihistamines deplete diamine oxidase (DAO) enzyme, suggesting that long-term use of antihistamines may eventually become counterproductive.

https://www.amymyersmd.com/2017/10/hist ... tolerance/

Best of luck to you, I hope the surgery and the recovery goes smoothly.

Tex

[Kilt]

I've thought of going on budesonide immediately when I start the antibiotic to prevent or lessen any impending flare.

Any thoughts on this course of action? Does it hold up to logic?

I don't have any expertise or experience with this exact question, but I have two opinions.

The first is that you should ask this question of both the doctor that is prescribing doxycycline and the doctor who has prescribed budesonide for you.

The second is that I believe that preemptive uses of antidiarrheals can be be both logical and effective. Before being diagnosed with LC, I could effectively control the watery diarrhea with 2-4 preemptive loperamide pills a day. Being now in the 11th week of a so far successful budesonide taper, I consider this whole treatment to be, in one sense, diarrhea preemptive in nature.

I have no opinion yet on the controversial subject of probiotics, but Florastor (a yeast) is widely reputed not to be affected by antibiotics and hence is often prescribed in connection with antibiotic treatments.

I note that the following site does not list budesonide as having any interactions with doxycycline, or vice versa:

https://www.drugs.com/drug-interactions/budesonide.html

Best of luck.

[Marcia K]

Hello, Chris. Not everyone likes probiotics, but I take them two hours after every dose of an antibiotic. I have not had D or gotten a yeast infection while on antibiotics like many women do. I take RenewLife Ultimate Flora, 30 Billion which is available at Wal-Mart. It's gluten & dairy free.

[Greengoddess]

I too take a probiotic called aflorex. They said to take it two hours after an antibiotic.