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I've had a horrid past two years with my health and pouch, starting with a sill mystery GI infection that needed a month on Cipro and Flagyl to clear. I ended up with thrush, multiple fungal infections, sinus infections after, went on augmentin later on, flagyl again (possible allergic reaction, rash, numbness in hands) and then developed an ulcerative colitis related inflamatory  condition in my lungs that took over a year to diagnose and finally treat with steroid inhalers. I had a bout of strep last year and apparently have it again. My brother got over a bout of c Diff recently and I have been in close proximity to him. My ENT insists that the strep must be treated even though my symptoms have mostly subsided. No more fever, sore throat etc, just some sinus problems, green mucus in my nose still. ENT wants to put me on penicillin but I am terrified of getting c Diff. Does anyone have any experience with this versus azyithromycin in terms of risks to c Diff infection and effectiveness for strep and sinus complications? I was under the impression that Macrolides are lowest risk for c Diff and also work on strep.

Sadly the lab initially lost my strep tets and the first rapid tests came back negative so I've already had this infection for almost 2 weeks. It feels odd to be taking an antibiotic when I longer feel very sick. At a loss for what to do. My ENT did her best to contact my pulmonary and GI docs and they seem to agree the step must be treated.

I'm just so cautious of antibiotics now after this 2 year roller coaster. Any time a take a course it starts a game of whack a mole so to speak, other problems arising. I have just recently felt back to normal in the last two months after so long. Would hate to start the slide again.

Tags: infection, Macrolides, strep, Penicillin, Azithromycin, ENT

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The reason your doctors are pushing treatment so strongly is that untreated strep has a tendency to seriously damage the heart and/or kidneys. The fact that it's already been untreated for two weeks might make treatment irrelevant, but no one has ever done that experiment (AFAIK), and only a fool would reassure you. 

You might be able to reduce the C. Diff risk by taking S. boulardi (Florastor) while on the antibiotic.

Ironically, the heart valve damage that can result from untreated strep requires antibiotic prophylactic treatment prior to things like teeth cleaning...

Scott F

I agree with your ENT to treat. Azithromycin would probably be the safer bet and maybe you could take probiotics with it, such as S. boulardii, which is supposed to help suppress C. diff. 

This is a very valid use for antibiotics and the sooner you treat the shorter duration of treament you need. Oh yeah, and stay away from your brother until you are done treating.

Jan

Jan Dollar

Thanks Jan and Scott. I started on penicillin. Nausea for sure otherwise fine. 

Got my kids tested and my 2 yr old tested positive for strep even though she no longer seems sick. My ENT and her new pediatrician (we just moved) are in total disagreement. My ENT says treat her and squash it lest the strep make the rounds in the family and the Pediatrician says leave her be since she is as asymptomatic now. I'm certainly concerned with my history of lung and sinus infections and now "UC of the lung" as my Pulmo sort of put it. And of course I don't want to put her on antibiotics for no reason, but this seems like a decent reason. 

J

Don't you just love it when experts disagree!?

But, it seems like your pediatrician is looking only at the kid's angle, not the more global family thing. The idea is to look at it on a communicable disease basis and the fact that YOU do not need your daughter as a reservoir. I know that they are really clamping down on antibiotics for every little sore throat and earache, but, this is not that situation. 

Jan

Jan Dollar

Well now both my daughters (4 and 2) and my wife came back positive for strep A so it looks the whole family is going on a round of antibiotics. I'm now day 4 on the penicillin VK and have really bad nausea and a constant ache in my pouch. No loose stools, oddly I am going less.  I may have seem some blood in the stool last night which really freaked me out. Could have been the cherries in the Lara bar I ate the day before. I have doubled my dose of Florastor and Culturelle. 3 more days to go on the penicillin for me. Today stool seems fine and last night if it was blood it was congealed and probably up past the pouch since it was pretty dark in color. 

J

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