HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For Persistent Sore Throat While On Clindamycin And Azithromycin

Posted on Wed, 1 Mar 2017

Question: Over the last three months I have had on and off sore throat and tonsillitis. I've been given clindamycin and azithromycin to no avail. until CBc results indicated viral infection so I didn't understand why I was put on a antibiotic regime. regardless I followed the instructions. During this time I noticed an up and down elevated creatine kinase (moderately to markedly) and Alt(mild to moderate). Tonight I tested myself and my alt, ast, and creatine kinase were very elevated. 344 (8-37AST normal range) >14000 (0-232 creatine kinase normal range)alt 157 (normal range 12-78). I'm negative for HIV at the 3 month mark with fourth generation testing. I have no idea what's wrong with me or what type of doctor I need to see to get answers...I'd like to note that these symptoms appeared one week after I had unprotected sex with a woman I met at a bar and performed oral sex.

Answered by Dr. Ramesh Kumar (1 hour later)

Brief Answer:
Side effect of long term antibiotic.

Detailed Answer:
Hi
Thanks for your query.
Have noted all your details.
Moderate elevation of liver enzymes are common after long term use of antibiotics,As per your history you are having pharyngitis from almost 3 months and you are on broad spectrum antibiotics off and on for that.Most of the antibiotics are metabolised by liver,Hence sometimes they derange functions of liver.I would recommend you to take a liver protector like Sylimarin for a few weeks.
Self tested levels of liver enzymes are not reliable so i would recommend you to get readings from a proper lab.Appearance of symptoms after unprotected sex is just a coincidence.As symptoms of HIV take atleast 4-8 weeks to manifest,And usually loose stools are the earliest symptoms.
However i would suggest you to go for HIV-PCR test.
USG abdomen.
Serum bilirubin
Complete blood count
Repeat liver function tests.
As per your question you should follow up with reports of above mentioned tests with a Gastroenterologist.
Thanks!

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Ramesh Kumar (3 hours later)

I haven't been on any antibiotics for about a month now. the test results were conducted at the hospital lab I work at so I'm confident in the accuracy of the results. Also, the markedly elevated creatine kinase seems to point to muscle involvement. Though my alt and ast were elevated my Direct and total bilirubin was normal as was my platelet count. See attached...

Answered by Dr. Ramesh Kumar (14 hours later)

Brief Answer:
Follow up advice.

Detailed Answer:
Hi again
In that case i would suggest you to go for a USG whole abdomen to find out the cause of deranged LIver function tests.
Start taking Sylimarin daily and follow up with reports of ultra sound.Any further investigation depends on ultrasound report.

Thanks

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Remy Koshy