Azithromycin in Udon area? Urgent

[randymarsh]

Does anyone know if I can buy Azithromycin over the counter in any pharmacies around Udon / Nong Khai area?

I've been given norfloxacin for bacterial infection (diarrhoea, fever) but the more I read about this type of drug, the less I want to take it.

Been reading Azithromycin is a good choice now for diarrhoea treatment but the hospital I was on doesn't have any. I need to find some pretty urgently.

Thanks for help

[lopburi3]

Suspect most would have but must be pharmacist on duty as considered dangerous drug

Available Brands

Azith [ Siam Bheasach ] Azithrin [ T. O. Chemicals ]

Azithro [ M & H Manufacturing ] Azycin [ GPO ]

Azyter [ Laboratoires Thea ] Binozyt [ Sandoz ]

Floctil [ Unison ] Meithromax [ Meiji ]

Onzet [ M & H Manufacturing ] Zithromax [ Pfizer ]

Also marketed as

Zmax [ Pfizer ]

[randymarsh]

Thanks a lot. Will look tomorrow.

Considered dangerous by the Thais? Yet theyll hand out the stuff they have me (Google it.. Black box warnings, diacontinued lots of countries, permanent nerve / tenden damage... Could go on). Mentioned the risks to the doctor but it was all brand new information to him.

[lopburi3]

Dangerous is a class of drugs - and norfloxacin is in the same class.

[Sheryl]

Most drugs have potentially scary side effects, azithro is no exception.

With both norfloxacin and azithro, the serious side effect are rare.

Compare: http://www.mayoclinic.org/drugs-supplements/norfloxacin-oral-route/side-effects/drg-20072239 and http://www.mayoclinic.org/drugs-supplements/azithromycin-oral-route/side-effects/drg-20072362

If you are not experiencing problems with the drug originally prescribed I would stay with it. Though azithro does have the advantage of single dosing.

If you are determined to switch some suggested pharmacies are:

Nong Khai:

Kriang Sak Phesat Pharmacy tel 042-411 685

Nong Khai Pharmacy Shop tel 042-411 148

Udon Thani:

Muang Thong pharmacy in Udon (near the market)

and see also this list, with phone numbers https://en.panpages.co.th/search?page=1&per_page=20&q=pharmacy+Udon+Thani I don't know the geography up there but if any of the ones that also list "medical supplies" are in the vicinity of a large hospital, would be a good bet

[mark131v]

Have you had blood or stool samples taken??

Have they shown they will be effective against this strain of bacteria if indeed it is bacterial and not a viral infection against which antibiotics are useless?

If not why you even contemplating antibiotics for diahhorrea and fever as in probability it is un indicated and will be useless

Fluids, paracetomol for the fever and let it run it's course far too much giving out of AB's in Thailand and no wonder there are problems with resistance

Edited January 1, 2016 by mark131v

[randymarsh]

Thank you. I'd prefer to switch as I've taken Azithromycin before and as far as I know doesn't come with black box warnings like this other one. I know the severe side effects are rare but I get paranoid and when I'm sick the last thing I need is the stress of the supposed cure causing me even more problems.

[randymarsh]

Have you had blood or stool samples taken??

Have they shown they will be effective against this strain of bacteria if indeed it is bacterial and not a viral infection against which antibiotics are useless?

If not why you even contemplating antibiotics for diahhorrea and fever as in probability it is un indicated and will be useless

Fluids, paracetomol for the fever and let it run it's course far too much giving out of AB's in Thailand and no wonder there are problems with resistance

Yes I was admitted to hosiptal last night because had a lot of blood in diarrhoea...and had blood and stool tests. Stool showed a bacterial infection. Have told doctor my concerns about the med prescribed and he said switch to Azithromycin if I can find it.

Honestly last week has been a nightmare. I tried to let it run its course but I couldn't shake it off.. The fever has been severe at times. Then seeing all the blood yesterday, had to do something.

[mark131v]

Have you had blood or stool samples taken??

Have they shown they will be effective against this strain of bacteria if indeed it is bacterial and not a viral infection against which antibiotics are useless?

If not why you even contemplating antibiotics for diahhorrea and fever as in probability it is un indicated and will be useless

Fluids, paracetomol for the fever and let it run it's course far too much giving out of AB's in Thailand and no wonder there are problems with resistance

Yes I was admitted to hosiptal last night because had a lot of blood in diarrhoea...and had blood and stool tests. Stool showed a bacterial infection. Have told doctor my concerns about the med prescribed and he said switch to Azithromycin if I can find it.

Honestly last week has been a nightmare. I tried to let it run its course but I couldn't shake it off.. The fever has been severe at times. Then seeing all the blood yesterday, had to do something.

In that case buddy sorry for being so judgmental it is just I see a lot of this in Thailand and much of the time it is completely un-indicated

If the hospital have prescribed the antibiotics after the samples came back then I would be tempted to stick with them as they are obviously effective against this strain of bacteria, that said azithromycin is a good option and the dosage is easier just don't forget to eat some probiotics when you are well again as they do tend to wipe out everything even the good stuff..

Get well soon!

[randymarsh]

Thanks

Any advice on best probiotics? Where can I buy them?

[randymarsh]

Managed to get some. I'm right to think the dose is single 1000mg?

I've already taken two norfloxacins yesterday so I'm a little wary now on whether to change anyway. Concerned about stopping after a day... Could it build up resistance?

[randymarsh]

Found a lot of good information here which can be summarised in my opinion to say Azithromycin is the way to go. It specifically calls out its use for treatment in Thailand, and as a second line option if norfloxacin is ineffective... So I think I should be ok to switch.

[randymarsh]

Sorry can't copy the link on my.phone but its some US health website PMC about clinical studies into treatment of diarrhoea

[randymarsh]

Prevention and Self-Treatment of Traveler's ...

www.ncbi.nlm.nih.gov PMC1539099

by DJ Diemert - ‎2006 - ‎Cited by 77 - ‎Related articles

[Sheryl]

It is always preferrable not to have an incomplete course of an antibiotic as that can indeed contribute to resistance. I don't know how long a course of norfloxacin you were given, usually it is only for 3-5 days, if you can complete at least 3 days it would be best.

Regarding the "black box" warning you are concerned about it is usually this:

"Fluoroquinolones are associated with an increased risk of tendinitis and tendon rupture; this risk is further increased in older patients, usually those older than 60 years; in kidney, heart, and lung transplant recipients; and with use of concomitant steroid therapy

May exacerbate muscle weakness in patients with myasthenia gravis; avoid fluoroquinolones with known history of myasthenia gravis"

Obviously you do not have myasthenia gravis so that part is of no concern and presumably you have not had an organ transplant and are not on corticosteroids. I don't know your age but if under 60, that further reduces the risk.

The incidence of tendinitis/rupture in people taking norfloxacin who do not have specific risk factors is extremely low, less than half of one percent. It is also more likely to occur with long courses of the drug (i.e. two weeks or more). http://cid.oxfordjournals.org/content/36/11/1404.full

If you decide to switch to azithro, the dosage can be either a single dose of 1,000 mg or 500 mg a day for 4 days. The single dose may produce nausea.

For probiotics, easiest to get is just yogurt -- real, unsweetened yoigurt not the sweetened stuff. Yolida brand is good and found in many tesco Lotuses. If yo ucan't find that Bulgaria will also do.

If you are still experiencing symptoms, activated charcoal (Ca-R-Bon, available in most 7-11s) will help a lot

[randymarsh]

Just reading more and more horror stories about that family of drugs even on short doses, so going to switch. The risk is small I know, but were talking about risks of permanent debilitating damage. My particular area of concern was on damagento the nervous system.

Thank for your advice. I was looking and ntocied another probiotic recommended, a capsule named

[randymarsh]

Infloran. Is that worth a try?

And sorry clicked Post by mistake and no edit option on mobile.browser that I can see.

[randymarsh]

The FDA is strengthening its warning that a popular class of antibiotics, called fluoroquinolones, may cause sudden, serious, and potentially permanent nerve damage called peripheral neuropathy.

Fluoroquinolones are antibiotics that are commonly used to treat a variety of illnesses such as respiratory and urinary tract infections. These medicines include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxacin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). More than 23 million patients received a prescription for one of them in 2011.

Peripheral neuropathy is damage to the nerves that send information to and from the brain and spinal cord and the rest of the body. Damage interrupts this connection, and the symptoms depend on which nerves are affected. In general, the symptoms are in the arms and legs and include numbness, tingling, burning, or shooting pain.

Peripheral neuropathy has been listed as a side effect of fluoroquinolones since 2004. There have been reports of long-lasting nerve damage and disability in patients taking this type of medication.

A recent FDA review revealed that the existing warnings for fluoroquinolones were inadequate. The FDA's newest alert requires that all drug labels and medication guides for fluoroquinolones be updated to better emphasize the risk for serious and potentially irreversible peripheral neuropathy.

http://www.webmd.com/brain/news/20130826/fda-strengthens-fluoroquinolone-warning

Edited January 2, 2016 by Sheryl
source of quote added by Moderator

[randymarsh]

Should I war until its out of my system completely. Took 400mg at 9pm last night. Saying half life is 3.5 hours so could take azith tonight...

[randymarsh]

4 hours - 200 mg / 50%

7 hours - 100 mg / 25%

11 hours - 50 mg / 13%

14 hours - 25 mg / 6%

18 hours - 13 mg / 3%

21 hours - 6 mg / 1%

25 hours - 3 mg / 0%

Source: Drug Half Life Calculator - Drugsdb.com http://www.drugsdb.com/resources/drug-half-life-calculator/#ixzz3w45ikB2t

[Camelot]

I've taken the fluoroquinolone 'levofloxacin' on and off for years after an ENT doctor recommended it for sinus infections. It works well and I've never had any side-effects. Maybe I've just been lucky or maybe the FDA is being over-zealous. It wouldn't be the first time.

[Sheryl]

I have edited your post to put in the source.

Please to not post verbatim excerpts without acknowldeging the source, otherwesie it is plagarism

Understand that the risk of peripheral neuropathy is extremely small; it is very, very rare complication. More than 25 million people a year take these drugs in the US alone, while the number of reported cases of neuropathy in people using these drugs is in the double digits. So you are looking at a risk that is less than 1 in 10,000.

[Sheryl]

You do not have to wait for the norfloxacin to clear to take the azithro. Entirely different class of drugs.

[Sheryl]

Infloran. Is that worth a try?

And sorry clicked Post by mistake and no edit option on mobile.browser that I can see.

You can -- but may be overkill IMO. Unless persistant problems develop, eating yogurt for a few days after you finish the abx should be plenty. Infloran is expensive and can be hard to find.

[NickJ]

Bio-Flor satchets are good and can be taken with anti-biotics. About 400b a box.

[Rhys]

Speak to your Pharmacist....

[randymarsh]

Wanted to get some opinions as I'm improving in some ways but not in others. It'll help if I start at the beginning.

Dec 26 - woke up middle of night incredibly cold, teeth chattering. Wrapped up in about five layers and managed to sleep though the rest of the night.

Dec 27 - diarrhea started. Anything I ate or drank would result in a trip to the toilet, usually within about ten minutes. Fever wise, was fluctuating between hot and cold.

Dec 28 - same as 27. Endless trips to toilet.

Dec 29 - fever really escalated so I went to hospital for blood tests. I got the all clear on dengue and malaria and was told I had influenza virus. Was given paracetamol and tamiflu and sent home. I never took the tamiflu but I have been on a very heavy diet of paracetamol pretty much constantly. At this point my concern was with fever rather than diarrhea... Honeslty I get upset stomach from.l time to time and it always passes but this fever was something else.

Dec 30 - stayed at home. Fever stable and diarrhea same as always.

Dec 31 - attention turns to diarrhea when notice a scary amount of blood in stool. Go to toilet maybe 15 times. Even when stomach is empty, just blood coming out. This results in overnight stay in hospital, IV antibiotic dose which nearly knocked me out, and hydration drip all night. I woke up in middle of night wet through and freezing, felt very much like how it had all started back on 26th. Nurse said had a risk of going into shock and was given hot water bottle.

Jan 01 - Wake up and provide stool sample for testing (I did this after being treated with IV antibiotics the night before). There was no blood, I presume the IV treatment had helped. Doctor later confirms bacterial infection and prescribes norfloxacin. I take two tablets, morning and evening. Visits to toilet down from average of 20 to about 3. Sleep uninterrupted.

Jan 02 - change treatment to Azithromycin. Feeling generally better and more hydrated. Stool still not solid but has changed colour and no blood. No signs of fever so no need for paracetomol before bed. However, wake up 2am freezing again and with need to go to toilet. Go two times, not solid but no blood. Wrap up again and get back to sleep eventually.

Jan 03 - toilet when wake up, same as in the night, not solid but no blood. Feeling cold and weak.

So my thinking on all of this is I have a viral infection, influenza, which caused my diarrhea. At some point, I got a bacterial infection which has now cleared up (I hope... no more blood etc), but I'm still left with virus which is still giving me stomach problems. Sound logical? I'm considering going back to doctor for new blood and stool tests to confirm.

Plan today is to start eating yoghurt and see if that help my stomach. On the fever / feeling freezing, I guess I just have to wait and hope

[Sheryl]

It is worrying that you still have fever with chills. You need to see a doctor and get repeat blood work.

What hospital has been treating you?