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Old Thu Oct 8, 2009, 11:16 PM
Hopeful Hopeful is offline
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Safe Antibiotics?

Hi,

I need to have an abnormal mole excised. The surgeon wants me to take Keflex prophylactically. Keflex has AA, thrombocytopenia, and kidney toxicity listed as potential side effects. Are there any "safer" antibiotics that others have taken? My WBCs are usually around 3 and my ANC is low normal. Are prophylactic antibiotics really necessary?

Thanks for any advice or shared experience!
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55 yo female, dx 9/08, AA/hypo-MDS, subclinical PNH, ATG/CsA 12/08, partial response. small trisomy 6 clone, low-dose cyclosporine dependent
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Old Fri Oct 9, 2009, 09:24 AM
Marlene Marlene is offline
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John was on that when he broke his wrist and his counts were much lower than yours at the time. He had no problem with it. But the ortho doc consulted with our hematologist regarding John's SAA. I assume the course of antibiotic will be just prior and after for 24 hours.

Come to think of it, they also gave him that for his knee surgery just prior and after surgery.

You may want to check with your hematologist and pose that question to him/her.

If you're not on cyclo anymore and your ANC is that high, then risk is probably lower for a secondary infection. I would also ask if they put everyone on this who has this procedure or is it because of your SAA.
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Marlene, wife to John DX w/SAA April 2002, Stable partial remission; Treated with High Dose Cytoxan, Johns Hopkins, June 2002. Final phlebotomy 11/2016. As of July 2021 HGB 12.0, WBC 4.70/ANC 3.85, Plts 110K.
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Old Sat Oct 10, 2009, 04:15 PM
squirrellypoo squirrellypoo is offline
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Just to add another onto the list, I've been on phophylactic Azythromycin since I was discharged from my transplant (and will continue to do so for the rest of my life, I'm told).
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36/F - 1984 SAA treated with ATG [complete remission until] Oct 08 - burst blood vessels in eyes and low platelets; Jan 09 - AA & hypo-MDS; July 09 - BMT (RIC MUD PSCT) July 10 - 10k for Anthony Nolan (1yr post BMT! 53:48) Sep 10 - Wedding! I've run 5 marathons now!! (PB 3:30!)
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Old Sat Oct 10, 2009, 08:33 PM
Laura Laura is offline
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That is interesting that they told you would be on it for the rest of your life. I am told I will be on Penicillin for at least a year.

Laura
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Laura; dx SAA; MUD transplant June 18, 09; ITP June, 2011; fighting multiple complications/GVHD and now low counts again...
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Old Sun Oct 11, 2009, 05:46 AM
Lisa V Lisa V is offline
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When Ken had surgery to remove a basal cell carcinoma from his eyelid, it became infected and the doctor prescribed Bactrim (Septra). Imagine my surprise when I looked up the possible side effects and found aplastic anemia listed as one of them! I called the hem/onc dept. pharmacist and asked him if there was a safe substitute. He told me that practically all antibiotics carry that risk, just because of the way they work. He said some are worse than others, though, and recommended switching to Cephalexin.

The Bactrim thing really surprised me, given that many AA patients are routinely prescribed it for PCP prophylaxis! Doesn't this seem like a bad idea? Ken's doctor doesn't believe in routine prophylaxis, so he's never taken any.
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-Lisa, husband Ken age 60 dx SAA 7/04, dx hypo MDS 1/06 w/finding of trisomy 8; 2 ATGs, partial remission, still using cyclosporine
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Old Sat Oct 17, 2009, 02:56 PM
Mimi C Mimi C is offline
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Vancomycin

My mom is on high doses of Vancomycin for pneumonia. Levaquin wasn't getting the job done alone. Now I read that Vancomycin is an antibiotic that can cause bleeding (listed on www.pdsa.org). My mom's platelet count is at 7 today. Are there other options we should be looking at?
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Mimi, daughter of Lucy age 77, diagnosed MDS Jan. 09; Vidaza Jan 09-Jun 09 no improvement; Clofarabine clinical trial Oct 09-Feb 10 mild improvement in blasts; blasts 4% in Aug 09; 30% Sep 09; 2% in December; 30% in March; AML diagnosed April 2010 .
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