Oral surgeon's office sent me a prescription for amoxicillin to be taken in conjunction with a dental procedure later this week.

What is the best way to prevent or minimize the raging diarrhea that always accompanies amoxicillin for me?

Ask for a different antibiotic

quote:

Ask for a different antibiotic

What would you suggest as an alternative?

The prescription that I have is for 21 ea. of 500 mg amoxicillin tablets, two to be taken one hour prior to the surgery, then one each 8 hours until they are all used.

Couple of notes; I have received suggestions to accompany the antibiotic with bismuth (Pepto-Bismol), and other suggestions to take a probiotic.

Also note, the doc's office might have specified amoxicillin because that is one of the meds that are free at Publix pharmacy.

Not a Dr or Pharm, but appreciate your issue.

I eat yogurt, and take probiotics.

Also a slice of cheese at each meal, while taking amoxicillin.

That helps me, I hope it helps you.

Probiotics and yogurt are your best bet. I would start them a couple days prior to the initial antibiotic dose. Any antibiotic can cause the issue you’re worried about but specific antibiotics are recommended for a reason. Do you have orthopedic implants or cardiac implants? I would assume the oral surgeon is choosing that antibiotic for a particular reason.

If you have raging diarrhea with amoxicillin, then Augmentin (amoxicillin + clavulanate) is out, since its diarrhea side effect is worse. Clindamycin is a good alternative for pre and post dental treatment. No way of knowing how your gut will react to it, however, since it appears that you have never been on it.

quote:

Originally posted by armedmd:

Do you have orthopedic implants?

Structural support was installed May 2013 following a fracture. I'm not sure that the oral surgeon knows about it; I do not recall him asking, and I never thought to bring it up.

VTail, give a little online read about canned or pureed pumpkin for this. Serch its use for people as it gets used in pets often and works. It works on people too.

quote:

Originally posted by V-Tail:
Oral surgeon's office sent me a prescription for amoxicillin to be taken in conjunction with a dental procedure later this week.

What is the best way to prevent or minimize the raging diarrhea that always accompanies amoxicillin for me?

You DID notify your oral surgeon's office first thing, right?

quote:

You DID notify your oral surgeon's office

I did not. I assumed (oops!) that this would be an effect of antibiotics in general, not specifically confined to amoxicillin.

I usually recommend probiotics when someone is on an antibiotic. However, it would be wise to speak with your physician regarding this. There are other antibiotics that can potentially be used that may not cause this issue for you.

Good Afternoon..

Last summer I had to visit the Minute Clinic for a sinus infection before heading off to ND.

The PA asked me if I wanted one of two kinds of Amoxicillin. After asking she informed me that one was what I would call normal grade but the other one was equivalent to a +P round. She also stated that one of the main side effects is diarrhea.

Two other antibiotics that may be a possibly are ciprofloxacin

or.

Doxycycline (dependant on what the procedure is)

I cannot take Ciprofloxacin as it does horrible things to me. This is also the case with my father.

I can take Doxycycline with no problems. We were given Doxycycline before we headed out the door to Afghanistan, and I was fine. One of the side effects is that you can get a nasty sun burn. I didn't have a problem and I got a great tan.

Some of the soldiers stated that they had weird dreams but again I had no problems.

quote:

Originally posted by V-Tail:
I assumed (oops!) that this would be an effect of antibiotics in general, not specifically confined to amoxicillin.

Different people react differently to the same med. That's the way it is in medicine. Some get diarrhea. Others don't.

quote:

Structural support was installed May 2013 following a fracture. I'm not sure that the oral surgeon knows about it; I do not recall him asking, and I never thought to bring it up.

The principle of giving amoxicillin for dental procedures is that, during dental and mucosal manipulations, you can potentially let loose the oral bacteria (specifically the viridans Streptococci) and seed your blood stream with them, leading to possible infections in various parts of your body, the most worrisome being the heart and more specifically the heart valves. So, catch them bug early before they can do real damage. Amoxicillin is cheap and effective for this task. They used to give amoxicillin left and right for dental procedures, but over the years, guidelines have changed as more data accumulated, and currently, there are only a very few specific medical conditions where antibiotic is truly recommended when you undergo a dental procedure.

Per the AHA (American Heart Association):
https://www.heart.org/en/healt...fective-endocarditis

"People with the highest risk for poor outcomes from infective endocarditis (IE) may be prescribed antibiotics (IE prophylaxis) prior to certain dental procedures to reduce their risk of developing it. These include procedures that involve manipulation of gingival (gum) tissue or the periapical region (area around the roots) of teeth, or perforation of the oral mucosa.

Antibiotic prophylaxis is reasonable before the above-mentioned dental procedures for people with heart valve disease who have any of the following:

- Prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts.
- Prosthetic material used for heart valve repair, such as annuloplasty rings, chords or clips.
- Previous IE.
- Unrepaired cyanotic congenital heart defect (birth defects with oxygen levels lower than normal) or repaired congenital heart defect, with residual shunts or valvular regurgitation at the site adjacent to the site of a prosthetic patch or prosthetic device.
- Cardiac transplant with valve regurgitation due to a structurally abnormal valve."

You didn't mention any heart issues, so I'll assume none. So, from the heart standpoint, you don't need any antibiotic.

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Now, for the hardware in your bones/joints (hip), the ADA (American Dental Association) doesn't even recommend giving prophylactic antibiotic when you undergo a dental procedure.
https://jada.ada.org/article/S...t?nav=rotatorJanmain

"In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection. The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use."

So, unless you have a "significant medical risk", I'll say you don't need any antibiotic, but, as always, discuss with your doctor/surgeon, since they know about your case more than any of us on the sideline.

For routine dental procedures no antibiotics are needed.

Different antibiotics have varying degrees of side effects. The antibiotic depends on what he or she is trying to prevent or kill. I believe in this case it is prevention.

I would ask for a different antibiotic. Probiotics and the other suggestions may help. Don’t bet the farm on it though.

What Q said.

Maybe try Immodium.

After my hip replacement my surgeon told me to always take 2 amoxicillin an hour before any invasive procedure, regular dental visits included.

Not a doc.

But from past experiences -if you generally experience diarrhea in these situations it never hurts to double up on high content fiber foods beforehand.

Strangely enough, I have found MREs to be great for getting over diarrhea. If you've ever eaten these you know why...

Oral surgeon is tomorrow. Regular routine visit with my primary care doc today, discussed the situation.

He said that if the oral surgeon had contacted him, primary doc's recommendation would have been to forego the antibiotic, but he was not going to countermand the prescription.

He recommended, as many of you have in this thread, probiotic, yogurt, cheese, etc., as preventive measures for the diarrhea, and bismuth (Pepto Bismol) if needed.

I'm really not looking forward to tomorrow.

V-Tail, hope it goes well-