Wednesday, 18 October 2017

09:41 – It was 35.5F (2C) when I got up at 0700. Colin must’ve been tired. Instead of following me out of the bedroom as usual, he just stayed crashed out on the bed with Barbara. He finally wandered out at about 0745, looked up at me, and whined. So I took him out.

The antibiotics appear to be doing the job. I’m still not breathing completely freely, but it’s a whole lot better than it was.

I thought it was interesting that Dr. Ambler prescribed both azithromycin and cefpodoxime to be taken at the same time. My guess is that he was concerned that whatever organism is causing the problem might be resistant to azithromycin, and he didn’t want to dick around.

Co-dosing antibiotics and similar dosing strategies are getting more and more common as resistant bacteria become increasingly common. Using older antibiotics that have fallen out of favor is also getting common. For a long time, sulfa drugs were seldom prescribed, both because of their side effects and because many bacteria had developed resistance. After a decade or two of being used infrequently, the side effects are still an issue, but many formerly-resistant bacteria have lost that resistance. Even chloramphenicol, which kills about one in 20,000 or 30,000 patients who receive it, is being used a lot more frequently than it has been for the last 50 years.

One coping strategy that intrigues me is alternate dosing. Rather than administer antibiotics A and B simultaneously, you administer a dose of A but when it’s time to administer the second dose of A, you instead administer B. Then A, then B, then A, then B, and so on. So far, that’s known to work with only a few antibiotics with a few specific bacteria, but research on it continues, and it’s yet another arrow in the quiver. It’s odd that a specific species of bacteria can be immune to either A or B administered separately, and to A and B administered together, but not to A and B administered alternatingly.