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Antibiotics again

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Thanx for the info Marjorie. I did review your comments last week re.

antibiotics. What concerns me most is that you identified my course

as untraditional. May I ask in what way? My derm. is sympathetic and

rosacea friendly and I am fairly well informed, but sometimes one

forgets to ask pertinent questions especially when out of one's

speciality. I'm guessing that the four week run is short, but how is

the dosage, 500 mg twice a day, untraditional? She, the derm., seemed

to suggest that such a pattern would be how I would progress with

managing the disease, ie, 4 week courses of antibiotics when my

rosacea flared. I have a degree in physics, but understanding and

managing this disease is more complicated than anything I can imagine.

thanks for your help,

Deryk

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Oh, Deryk, I didn't mean to raise your concerns at all. I'm glad you

posted, so I can better articulate what I meant.

Practicing medicine really is as much an art as a science. Your

physician's prescribing schedule may be part of her magic in caring

for rosacea, based on years/decades of experience. Traditionally

tetracycline is prescribed 250 mg every 6 hours; there's nothing

wrong with 500 mg every 12 hours -- it's the same 1 gram dose, and

it's certainly easier to remember to take twice instead of four times

a day. (As a physics major, you may enjoy imagining the difference in

blood level between a drug given every 6 hours, or twice the dose

given half as often. There are different pharmacokinetics, and I can

only guess whether for rosacea they are important or irrelevent).

A four week course is short, but she probably wants to reassess you

after those four weeks, and depending upon your progress or lack

thereof, will treat you further. It may be all you need is 4 weeks,

or maybe you'll need more time, or a different antibiotic or a

different strength.

It sounds like you trust her. I've not heard anything to suggest you

do anything other than relax and let her care for your skin, let her

work her magic, and see what happens over the next few months.

I always ask to forget pertinent questions too. I'm not shy about

calling the office and leave the question and a request for the

doctor or the staff to call me back with the answer. If the questions

are not urgent I write them in my Visor to remind myself to ask at

the next visit. As a physician, I always like it when a patient asks

questions, at the time or when they call back. Dare to dream about

the patient who actually pulls out his/her Visor and fields me their

questions! <g>

Marjorie

Marjorie Lazoff, MD

>

> Thanx for the info Marjorie. I did review your comments last week

re.

> antibiotics. What concerns me most is that you identified my

course

> as untraditional. May I ask in what way? My derm. is sympathetic

and

> rosacea friendly and I am fairly well informed, but sometimes one

> forgets to ask pertinent questions especially when out of one's

> speciality. I'm guessing that the four week run is short, but how

is

> the dosage, 500 mg twice a day, untraditional? She, the derm.,

seemed

> to suggest that such a pattern would be how I would progress with

> managing the disease, ie, 4 week courses of antibiotics when my

> rosacea flared. I have a degree in physics, but understanding and

> managing this disease is more complicated than anything I can

imagine.

>

> thanks for your help,

> Deryk

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