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I Am A 33 Year Old Male. I Was Recently
Question: I am a 33 year old male. I was recently placed on Clindamycin (300 mg, 3 times per day, for 7 days) for an infected cyst on my back that was excised. I have finished one day of the Clindamycin, but have since read very concerning things about the frequency and risks of gastrointestinal side effects, specifically C. Diff. infections.
I am getting ready to go on a trip out of the country for approximately ten days. When I leave, I will be on day 5 of the antibiotic course. I am concerned about contracting C. Diff. while on the antibiotic, and probably would have requested something else if I had known of the (apparently) significant and common risk associated with this particular antibiotic.
1) Is the risk of C. Diff. really as high as I'm led to believe from the countless accounts one can read online, the FDA "black box" warning, etc.? Should I indeed be concerned, or is the risk of C. Diff. statistically significant, but low in practice?
2) If so, what can I do to reduce my risk? I have begun to take probiotics, but I am not really sure if I should take more than once per day.
3) I also take pantoprazole (40 mg) for acid reflux. Should I continue with this as prescribed, or is there a risk that it will increase the risk of upsetting my gut flora and, thus, increase risk of C. Diff infection? The worst thing I can imagine is being seated on an airplane with the type of diarrhea I see people with that infection report.
I am getting ready to go on a trip out of the country for approximately ten days. When I leave, I will be on day 5 of the antibiotic course. I am concerned about contracting C. Diff. while on the antibiotic, and probably would have requested something else if I had known of the (apparently) significant and common risk associated with this particular antibiotic.
1) Is the risk of C. Diff. really as high as I'm led to believe from the countless accounts one can read online, the FDA "black box" warning, etc.? Should I indeed be concerned, or is the risk of C. Diff. statistically significant, but low in practice?
2) If so, what can I do to reduce my risk? I have begun to take probiotics, but I am not really sure if I should take more than once per day.
3) I also take pantoprazole (40 mg) for acid reflux. Should I continue with this as prescribed, or is there a risk that it will increase the risk of upsetting my gut flora and, thus, increase risk of C. Diff infection? The worst thing I can imagine is being seated on an airplane with the type of diarrhea I see people with that infection report.
Brief Answer:
You probably don't need clindamycin at all
Detailed Answer:
Hi Kjelly222,
1) The absolute risk of c. difficile is very low. 2) you can do nothing to modify your risk. 3) Pantoprazol is OK to take.
More important than the above, why were you prescribed clindamycin? Before incision of the cyst? If so, you do not need antibiotics after incision. If you have been prescribed antibiotics after incision because it looks infected, I would recommend a simple penicillin instead of clindamycin, unless you had cultures from the wound that showed bacteria only sensitive to clindamycin.
Hope this helps.
You probably don't need clindamycin at all
Detailed Answer:
Hi Kjelly222,
1) The absolute risk of c. difficile is very low. 2) you can do nothing to modify your risk. 3) Pantoprazol is OK to take.
More important than the above, why were you prescribed clindamycin? Before incision of the cyst? If so, you do not need antibiotics after incision. If you have been prescribed antibiotics after incision because it looks infected, I would recommend a simple penicillin instead of clindamycin, unless you had cultures from the wound that showed bacteria only sensitive to clindamycin.
Hope this helps.
Above answer was peer-reviewed by :
Dr. Raju A.T
The treatment was administered at an urgent care clinic (I recently relocated to a job away from my GP, and it was difficult to make an appointment with a dermatologist).
I was originally prescribed Bactrim after the cyst was removed because it was painful in the first place, and had pus when the incision was made and, I assume, this indicated an infection. After the first Bactrim dose, I had requested an alternative because I had a reaction to a sulfa drug years ago.
So, at this point, should I request a second substitution to the penicillin, should I continue with the clindamycin, or consider stopping antibiotic treatment altogether? Would the very act of switching antibiotics again at this point cause complications of its own?
I was originally prescribed Bactrim after the cyst was removed because it was painful in the first place, and had pus when the incision was made and, I assume, this indicated an infection. After the first Bactrim dose, I had requested an alternative because I had a reaction to a sulfa drug years ago.
So, at this point, should I request a second substitution to the penicillin, should I continue with the clindamycin, or consider stopping antibiotic treatment altogether? Would the very act of switching antibiotics again at this point cause complications of its own?
Brief Answer:
No need for antibiotics
Detailed Answer:
Hi again,
From what you describe, I would say that there is no need for antibiotics altogether, i.e. no need to switch to another antibiotics or to stay on clindamycin. The treatment of an abscess, or an infected cyst, is incision and drainage. This treatment cured you, and there is no place for antibiotics. If the main problem is pain, I suggest aspirin and non-steroidal anti-inflammatory drugs for a few days.
Hope this helps.
No need for antibiotics
Detailed Answer:
Hi again,
From what you describe, I would say that there is no need for antibiotics altogether, i.e. no need to switch to another antibiotics or to stay on clindamycin. The treatment of an abscess, or an infected cyst, is incision and drainage. This treatment cured you, and there is no place for antibiotics. If the main problem is pain, I suggest aspirin and non-steroidal anti-inflammatory drugs for a few days.
Hope this helps.
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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