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Subject: Re: Need advice -- problem with Augmentin
From: (Steve Dyer)
Date: Wed, 24 May 2000 06:17:36 GMT

In article <8gfl24$jcd$>, dss1951  <> wrote:
>> Doc prescribed augmentin for my sinusitis/bronchitis (almost pneumonia).
>> Started last night.
>> Major Diarrhea today -- I mean the liquid  is flowing.
>> Any suggestions???
>Yep. Call Doctor immediately and don't take any more augmentin.  The
>antibiotic has dramatically changed your intestinal flora and you are
>at risk of developing pseudomembraneous colitis.  Get a different
>antibiotic soon as possible.  Keep yourself hydrated until the diarrhea
>stops. Call your doctor or whoever is taking his calls.

Oh, puhlease.  I won't quibble with the need to stay hydrated and to call
the prescribing doctor right away for instructions on what to do next,
but there's no need for this fearmongering; Augmentin and its individual
component drugs, amoxicillin and clavulanic acid, are all notorious for
causing diarrhea--particularly clavulanic acid, which has little or no
intrinsic antibiotic activity.  There's evidence that clavulanic acid
alone or the combination of the two drugs can increase gut motility--
causing diarrhea--independent of any effect on bacteria flora.
Steve Dyer

Subject: Re: Need advice -- problem with Augmentin
From: (Steve Dyer)
Date: Thu, 25 May 2000 04:24:37 GMT

In article <8gi3cd$c7f$>, dss1951  <> wrote:
>I don't know where Steve Dyer got his medical degree.  He missed the
>day they taught about pseudomembraneous colitis.  Telling the truth
>about antibiotic induced colitis is not fearmongering.  You have taken
>the appropriate measures.  Good Luck.

Augmentin causes diarrhea rather frequently, and the vast majority of those
cases aren't due to overgrowth of C. difficile, but a characteristic effect
of that drug combination on intestinal motility.  That's why I described your
article as "fearmongering".  There was nothing wrong with your suggestions
for what he should do (which he did)--it needs to be brought to the attention
of the prescriber--just the accompanying editorial hysteria combined with an
apparent ignorance of Augmentin's propensity to cause diarrhea of a more
benign sort.
Steve Dyer

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