Hi Kristi ,
Regards the antibiotics - augmentin is peniclillin with potassium clavulanate, .
Bactrim is trimethroprim , a typical agent for urine tract infections with an added sulphur element . The sulphur element is an addition to increase its potency . These antibiotics are known as sulphonmides
I think the classes of antibiotics to avoid are :-
penicillins
sulphanomides
trimethroprim alone
penicillins with added culvanic acid
There is a 10 % cross over between penicllins and ceflosporins ( cefuroxime , ceftriaxone ). With anaphylaxis to co amoxiclav , I would be concerned about cef drugs .
With anaphylaxis to both I think i would / you should , avoid penicillin completely . There are newer antibiotics which are penicillin , sulphur and extra acid free .
I think , Macrolides :- are used in peniccilin allergic patients . I also think there is No conncetion to sulphr based drugs or trimethroprim
Erythromycin
Clarthromycin
Azithromycin
Clindomycin -
This is the information on them from the BNF ( british national formulary used by all doctors in the UK
Erythromycin has an antibacterial spectrum that is similar but not identical to that of penicillin; it is thus an alternative in penicillin-allergic patients.
Indications for erythromycin include respiratory infections, whooping cough, legionnaires’ disease, and campylobacter enteritis. It is active against many penicillin-resistant staphylococci but some are now also resistant to erythromycin; it has poor activity against Haemophilus influenzae. Erythromycin is also active against chlamydia and mycoplasmas.
Erythromycin causes nausea, vomiting, and diarrhoea in some patients; in mild to moderate infections this can be avoided by giving a lower dose (250 mg 4 times daily) but if a more serious infection, such as Legionella pneumonia, is suspected higher doses are needed.
Azithromycin is a macrolide with slightly less activity than erythromycin against Gram-positive bacteria but enhanced activity against some Gram-negative organisms including H. influenzae. Plasma concentrations are very low but tissue concentrations are much higher. It has a long tissue half-life and once daily dosage is recommended. Azithromycin is also used in the treatment of trachoma [unlicensed indication] (section 11.3.1).
Clarithromycin is an erythromycin derivative with slightly greater activity than the parent compound. Tissue concentrations are higher than with erythromycin. It is given twice daily.
For the role of erythromycin, azithromycin, and clarithromycin in the treatment of Lyme disease, see section 5.1.1.3
Spiramycin is also a macrolide (section 5.4.7).
Oral infections
Clarithromycin or erythromycin is an alternative for oral infections in penicillin-allergic patients or where a beta-lactamase producing organism is involved. However, many organisms are now resistant to macrolides or rapidly develop resistance; their use should therefore be limited to short courses. Metronidazole (section 5.1.11) may be preferred as an alternative to a penicillin.
Cautions
Macrolides should be used with caution in patients with a predisposition to QT interval prolongation (including electrolyte disturbances and concomitant use of drugs that prolong the QT interval).
Side-effects
Nausea, vomiting, abdominal discomfort, and diarrhoea are the most common side-effects of the macrolides, but they are mild and less frequent with azithromycin and clarithromycin than with erythromycin
.
Hepatotoxicity (including cholestatic jaundice) and rash occur less frequently. Other side-effects reported rarely or very rarely include pancreatitis, antibiotic-associated colitis, QT interval prolongation, arrhythmias, generally reversible hearing loss (sometimes with tinnitus) after large doses, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Intravenous infusion may cause local tenderness and phlebitis.
The absolute best professional to discuss this with is a microbiologist.
What symptoms did you have with the anaphylaxis ?
Steven johnson syndrome is miserable . Did you have the rash for ages ?
Infection its in itself enough to make us react and get us into a snowball of reactions . I see exactly where your at with this .
Have you / do you react to sulphites , as they are used as preservatives in IV drugs and are used to soften corn and bleach the flour ( maize startch ) so this may be contributing to your reactivity also gelatine , the sulphites are used to soften the animal hide . Since removing capsules ( gelatine ) and corn flour filler , sometimes pre gelatinised , from my meds I have been less reactive . Especially in my bowel . Gelatine will make me wheeze , especially if its on an empty stomach ( as is advised with many antibiotics )
I tolerate , kiddie antibiotics
and IV drugs without sulphite preservatives . This is generally powders which the nurses mix with water for injections prior to administartion . Liquids in vials are more likely to contain sulphite preservatives .
Just some ideas for you
Josie