antibiotic dangers

April 21, 2005 2:56 PM

Medical question: How dangerous is taking unprescribed antibiotics?

I know, I know, it's not a good idea, but what I want to know is all the dangers that could be associated with this.

Here's my situation:
I have what mostly likely is a urinary tract infection (blood in urine). I know it isn't a STD because I
have been tested while donating blood recently and haven't had sex since (nor use needles). I also have access to
some antibiotics (for reasons too complicated to go into) which, from what I read here would be able
to treat the infection (14 250mg tablets of ciprofloxacin, enough for a 7 day treatment of a mild/moderate infection).
I have taken ciprofloxacin once before, (infectious diarrhea while traveling) if that matters, and did not experience troubling side effects.

What I don't have is medical insurance.

My idea is to try the 7 day treatment with what I have, and if it clears up, no problem. If it doesn't then
I guess I need to find a way to see a doctor. How stupid is this? Very or kind of?

posted by anonymous to health & fitness (26 comments total)

Most STDs are not tested via blood draw, so please please PLEASE don't think you don't have an STD because you donated blood! You did NOT get an STD test at the blood bank. PLEASE see a doctor, go to the ER and tell them you can't pay, but GO! Blood in urine can be caused by any number of things, and I highly recommend NOT just downing antobiotics! GO!!
posted by tristeza at 3:11 PM on April 21, 2005

Planned Parenthood does STD tests for men and women, and their rates are based on your income and ability to pay.
posted by croutonsupafreak at 3:13 PM on April 21, 2005

You really shouldn't get medical advice online. That said, I don't believe Cipro is especially dangerous and it probably wouldn't hurt you to give it a try. You should get an STD test, but I don't believe it'd hurt to try the Cipro and see if that clears it up.
posted by null terminated at 3:16 PM on April 21, 2005

Most STDs are not tested via blood draw, so please please PLEASE don't think you don't have an STD because you donated blood!

DITTO.

Planned Parenthood does STD tests for men and women, and their rates are based on your income and ability to pay.

DITTO. You can even work out a payment plan with them.

You really, really need to go get a full exam.
posted by Specklet at 3:26 PM on April 21, 2005

I would listen to tristeza, her profession is listed as "STDs". So she would know.

Seriously, I would listen to her.
posted by deliquescent at 3:30 PM on April 21, 2005

The danger in using antibiotics casually (besides the risk of an allergic reaction) is basically that you won't wipe out the infection and that you'll end up with a resistant strain of whatever you've got. This is why you're supposed to completely finish a course of antibiotics even if the symptoms disappear early on. This is a risk not only to you but on a public health level, as the growing presence of antibiotic-resistant bacteria in the population makes antibiotics less effective.

That having been said, as a fellow member of the uninsured classes, I've taken unprescribed antibiotics with no ill effects and always maintain a cache for emergencies.
posted by IshmaelGraves at 3:36 PM on April 21, 2005

The problem is if it *doesn't* clear up in 7 days, you're out of antibiotics. The bacteria left in your urinary tract may develop partial cipro resistance - and if it gets worse before it gets better, the cipro-resistant bacteria may be a significant enough population that when you are treated by a doctor it won't work.

It sucks not to have insurance in the 'states, but go see a doctor. Barring that, load up on tons and tons of cranberry juice to clear up the infection.

Unprescribed antibiotics might not hurt *you* but you're risking adding to the hurt on humanity by resistant bacteria. But if you *must* take the cipro, avoid alcohol - in some cases it can interfere with the effectiveness of the drug.
posted by PurplePorpoise at 3:42 PM on April 21, 2005

sorry ... may have developed partial...
posted by PurplePorpoise at 3:43 PM on April 21, 2005

Planned Parenthood does STD tests for men and women

I would just like to add that I am a male, and have called PP asking for free or low-cost STD tests before, and they told me to take a hike and go to the county hospital instead, so be sure to try your local public medical facility as well.
posted by falconred at 3:45 PM on April 21, 2005

If it IS a UTI, cipro is exactly what they often prescribe. It's what I've gotten several times for UTIs. In fact, my doctor once gave me a scrip for cipro with three refills so that I could self-diagnose my UTIs and just fill the bottle rather than make an appointment to see her.

As I understand it, the main reason you shouldn't take antibiotics that aren't prescribed for you is that using them can promote the proliferation of drug-resistant bacteria, so you should only use them when you really need to kill off something. This is why it's very important to finish a prescription, even if you feel better--basically you need to make sure it's dead, otherwise you're selecting for the ones that took longest to kill. This is also why antibiotics are not OTC--if they were, way too many people will take them for viral infections and colds, etc., and they'd soon become useless.

(on preview: yeah, what they said!)
posted by statolith at 3:45 PM on April 21, 2005

For the record, when I had a urinary tract infection it was intensely painful. I don't think there were blood-in-urine issues. Who knows what's wrong? Get it checked out.
posted by duck at 3:57 PM on April 21, 2005

There are test strips that you can get over the counter to determine if you have a UTI. If I were you I'd get some of those to be sure that's what you're treating before you take the Cipro.

Also, I've had good luck in nipping several UTIs in the bud by taking Uva Ursi. I get it at the health food store and take it three times a day at the first sign of a UTI (I take a little baking soda along with it, and avoid cranberry and fruit juices because it requires alkaline urine to work properly). If I catch it early enough I can stop it in its tracks and then I don't have to go through all that pee agony and waiting for the doctor to call in a prescription.
posted by stefanie at 4:19 PM on April 21, 2005

You didn't mention crippling fold-you-over burning pain or needing to pee every five seconds. By the time my last UTI got to the blood-in-the-urine stage, that was my living hell until I got to a doctor, so I'm kind of doubting that that's what you've got. Also, if you're a boy, UTIs are hard to get and, from what I hear, harder to treat, so you'll want more than 7 days of whatever you treat it with. Go to a doctor.

Good God, America needs to have basic medical rights for citizens. This kind of shit is ridiculous. Okay, I'm going back to being utterly relieved that I live in Toronto now.
posted by heatherann at 4:20 PM on April 21, 2005

Echoing what's said above:

The only STD's that are tested for with a blood draw are: HIV, syphilis, Hep A & B, and (I may be wrong on this last one) herpes.

You cannot know if you have gonorrhea or chlamydia without a swab (or, depending on circumstances, a urine test).

Get thee to an ER, give a fake name if you must, and get your shit checked out.
posted by dirtynumbangelboy at 4:34 PM on April 21, 2005

You absolutely need to get this checked out.

A mild UTI can be treated without antibiotics, but once there is blood in the urine or bad back pain, that means the infection could have spread to your bladder/kidneys and that's a whole other story.

If it was just a skin infection or something uncomplicated, taking unprescribed antibiotics MIGHT be an okay idea. But you don't want to mess with your junk, yknow?
posted by elisabeth r at 4:39 PM on April 21, 2005

I'm not qualified to tell you what you should do, but I want to share my little UTI experience.

I had a little blood-in-urine and stinging, so I made a Dr. appt. It went away by the time I got to the office, but because everyone screams "get your shit checked out", I did. They did a cystoscopy (kind of weird, but not as unpleasant as you might think) and a CT scan (eww, needles, yucky. And Expensive! $6k+ before insurance). Everything was fine. Ok. Whatever. What if it happens again? "If it's not any worse, just ignore it." Riiight.

So it happens again a couple of times, and goes away. Hmm.

This whole time, my urine starts smelling worse and worse. Normally it's pretty mild, like I hear it's supposed to be, but it basically starts smelling like a poorly-cleaned public bathroom every time I go.

I'm getting sick of this, so I make another appt. Different Dr., but basically the same deal. He wants to do another cystoscopy and CT. I refuse the CT, but say ok to the cysto. No problems found.

A few days later, he calls, "the lab work came back, looks like you have a very mild infection". Prescribes 7 days of Cipro. I take it, no problems for the 7 days, and the odor goes away.

And then comes back soon thereafter.

So I prescribed myself 14 more days of Cipro, and haven't had a problem since.

Oh, and if you're not actually an emergency, the ER will just tell you to see a urologist, who will insist that you pay. There really is no point to going to an ER unless you're bleeding out.
posted by trevyn at 4:56 PM on April 21, 2005

Patient info on Cipro, for what it's worth...
posted by gimonca at 6:35 PM on April 21, 2005

Here are some reasons that it might not be a good idea:

1) It's against the law.

2) Allergic reactions to antibiotics can kill you. They can kill you when a doctor prescribes them, too, but in theory then it's the doctor's fault, not yours. At least your doctor's responsible for it. Rashes are the most common way for allergic reactions to manifest, but they can also cause fevers and hepatic failure, blood dyscrasias and anemias, and all sorts of other rare hard-to-spell things that you might not even realize were happening.

3) Antibiotics can alter your gut flora. Occasionally this is serious enough that your colon gets colonized by C. dificile, so named because it's difficult to get rid of it (the organism is antibiotic resistant). The symptom of this is painful, bloody diarrhea and damage to the large intestine results.

4) Tetracycline and the other -cycline antibiotics GO BAD and turn into DEADLY POISONS after a few months. (Permanent tooth discoloration and kidney damage are two of the effects to expect from expired *-cyclines.) If you're 'caching' these, please throw them all away immediately.

The last time some girl called me up and told me I might have chlamydia, though, I just went ahead and treated myself for it. The risks of a possibly-unnecessary short course of antibiotics seemed much preferable to a diagnostic urethral swab, even self-administered.

On the other hand, though, I'm a doctor and in theory might recognize it if something went horribly wrong. I'm not sure how to advise you, you not being one, and I'm also 100% sure that I don't give medical advice over the Internet, even to anonymous people. I'm also pretty sure that blood in the urine has lots of causes, of which only one is urinary tract infection. If I personally had blood in my urine, I would want to know why, stat, without any uncertainty in the process.

So I hope the above set of facts was useful, and I wish you luck.
posted by ikkyu2 at 6:45 PM on April 21, 2005

As far as I know, most counties have some sort of free STD clinic. If yours doesn't, drive to the next county that does.
This will be mildly embarassing. Get over it. You will be sharing a waiting room with some folks who obviously have lifestyle issues, it's OK. A lot of them just don't have insurance, and you probably won't run into anyone you know.
Usually a nice person will ask you some extremely personal questions, and it's best if you answer them honestly. They will smile at you pleasantly, they don't care and they've heard everything anyway. Then, not believing most of it, they will proceed to test you for every disease known to man that causes symptoms between the navel and the knees. If it turns out you have something not really interesting to them, they may offer you some free samples of medicine they happen to have around. If they think you need to go to an outside doctor, they will tell you. This is your tax dollars at work, and if you don't have insurance, the price is right. In any case, you'll probably know a lot more about your problem than you did when you came in.

"The Clap Clinic, the best health care money can't buy."
posted by unrepentanthippie at 7:31 PM on April 21, 2005

Excellent advice, ikkyu2, particularly the info about -cyclines becoming toxic over time.
posted by Civil_Disobedient at 10:12 PM on April 21, 2005

For a UTI, it usually only takes a three-day course to clear it up, so seven days is likely to wipe out the whole thing.

If you have blood in urine it may have spread into bladder or kidneys. A kidney infection is hella serious. So go to a doctor. But you might take a pill or two in the meantime, because nothing hurts worse than a UTI.
posted by mai at 12:01 AM on April 22, 2005

You raise an interesting question and some of the responses you received are erudite. The response I'll give only answers your question obliquely.

There have been quite a number of studies done to assess the safety of treating urinary tract infections without an office visit. There have been various triage schemes set up to enable the treatment of uncomplicated urinary tract infection without an actual face-to-face encounter with a physician. The bottom line with these studies is that "phone treatment" of simple UTI can be done with safety in a select patient population who fit a relatively narrow set of clinical parameters. So these studies, in a sense, mirror your situation: you want to know how sensible it is to treat your "bladder infection" without a formal medical evaluation. You can get a sense of what these triage methods are by looking here, here and here.

Regrettably, you would not qualify--in any of these triage schemes-- for "over the phone" treatment of UTI with isolated hematuria. Perhaps you would qualify if you mentioned dysuria, urgency and frequency....but you don't mention those symptoms. The conclusion has to be that treating yourself for "bladder infection" on the basis of the symptoms you report is a not insubstantial calculated risk.

Which, in summary, is pretty much the same advice that everyone else has given you.
posted by FredFeral at 9:09 AM on April 22, 2005

The last time some girl called me up and told me I might have chlamydia, though, I just went ahead and treated myself for it. The risks of a possibly-unnecessary short course of antibiotics seemed much preferable to a diagnostic urethral swab, even self-administered.

Most medical facilities in the US now do urine-based chlamydia testing, so please don't fear the swab. When in doubt, get checked out. Chlamydia can lead to profoundly bad outcomes in women (infertility, ectopic pregnancy, chronic pain, death).

This will be mildly embarassing. Get over it. You will be sharing a waiting room with some folks who obviously have lifestyle issues, it's OK. A lot of them just don't have insurance, and you probably won't run into anyone you know.

"Lifestyle issues"? Because they have sex? Wow. There are 15-16 MILLION new cases of STD in the US every year, so I'd be careful about labeling someone with an STD as having "issues". Probably about 2 in 5 of your friends have had or have an STD. 80% of us have oral herpes, remember (not always sexually transmitted, of course).
posted by tristeza at 10:30 AM on April 22, 2005

I can't find the link, but I read a news story that quoted a woman saying that her daughter had taken expired tetracycline to self-treat a bacterial infection. The girl ended up in a coma.
posted by exhilaration at 2:47 PM on April 22, 2005

Most medical facilities in the US now do urine-based chlamydia testing, so please don't fear the swab.

I am profoundly pleased to learn of it, on behalf of people with urethras worldwide. Thanks, tristeza.

When in doubt, get checked out. Chlamydia can lead to profoundly bad outcomes in women (infertility, ectopic pregnancy, chronic pain, death).

I second this wholeheartedly. Chlamydia is usually asymptomatic in men, but it can harm their fertility as well.
posted by ikkyu2 at 6:07 PM on April 22, 2005

"Lifestyle issues" in this context does not mean sex. It means they may smell funny because they are homeless. They might have overwhelming mental problems that preclude holding a job. They may be wearing an orange jumpsuit and handcuffs, and have a friend wearing a gun with them, it's the law in most areas they must be tested prior to incarceration. Some of them may be crack whores. Some of them suspect or know they have an STD, which is not a lifestyle issue, it's just a problem and they are to be respected for doing the responsible thing about it. The fact that you are in the same waiting room simply means you all have one thing in common, you could use some medical care, and you're probably broke. The correct etiquette here is to read a magazine or look at your shoes, and stand up when your number is called. Your name will not be mentioned.

If you learn something unexpected, well oops, but now you know it. If you don't, it's still a good source of free medical care. I think we have a group conscience that it would be a better choice here to be seen by a doctor. I'm just pointing out here's a way to do that, for free.

I stand by the statement that you're likely to leave with more information than you had going in, nothing more should be read into it.
posted by unrepentanthippie at 6:56 PM on April 22, 2005