Switching from Minocycline to Zithromax plus Accutane and Vitamin A consideratio

May 1, 2002

With a loading dose of 500 mg you'll get instant high blood levels of

zithromax. There is some question as to which antibiotic is most

anti-inflammatory, Minocycline or Zithromax. No one knows, and it

could vary depending on the patient. The dose of the zithromax is

too low, however, and this could clinically present a problem. Why

risk it -- do the higher dose of 250 qd after the loading dose.

Another thing to consider is to add 5mg/d of accutane to the

minocyline and see what happens. I don't think the 5mg/d of accutane

can negatively affect photoderm treatment -- it is so low. Another

thing for all those taking Accutane, should NOT be taking any

supplemental Vitamin A whatsoever, including multivitamins. Any

additional vitamin a can interefere with the therapeutic effects of

very low dose accutane and potentiate side effects.

One other option is to go for two weeks on Tequin 400 mg/d or your

favourite quinolone, and see if you have any gram negative

involvement. It should improve on the quinolone. If you don't

improve, you don't have gram negative involvement. Although, you

could just culture instead.

> > > I told the nurse at my derm's office that I want to be off

> > > antibiotics by my birthday (July 27th). She said thats fine,

but

> > > first she wants me to switch from Minocycline (100mgs 2x daily)

> > > to Zithromax. (250mgs 3x weekly) I told her about Photoderm

and

> > > how I cant do anything to make myself flush for a while. She

> > > said it shouldnt be a problem. But I've been screwed over by a

> > > doctor/derm's complete lack of knowledge way more than once now,

> > > and don't wanna just take her word for it. Does anyone here

know

> > > if switching from Minocycline to Zithromax will cause a flare?

I

> > > flared real bad when I tried to quit my Minocycline cold-turkey,

> > > but I guess the theory is if I switch from one antibiotic to the

> > > other I should be ok? Any thoughts?

> > >

> > > Adam

> > >

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