YANMD-Antibiotic TKO edition
January 18, 2019 1:24 PM   Subscribe

I took azithromyxin almost 24 hours ago and I'm still completely exhausted. I'm working on getting a different antibiotic, but what can I do to feel better now? The half life is 68 hours. I've tried food, water, probiotics. Dr and pharmacist were no help. I had to cancel everything today. Does anything help counteract?
posted by mermaidcafe to Health & Fitness (11 answers total) 3 users marked this as a favorite
What are you taking it for? Are you sure that you are not exhausted because you are fighting off an infection?
posted by hydropsyche at 2:42 PM on January 18, 2019 [2 favorites]

Response by poster: Yes. I didn't have these symptoms before. About 20-30 minutes after taking last night's dose, I got really woozy and spacy and eventually that just turned into very very tired.
posted by mermaidcafe at 2:47 PM on January 18, 2019

Antibiotics should only be changed or stopped if you are having a serious allergic reaction (vomiting, difficulty breathing, certain bold rashes, etc.)

If your doctor and pharmacist didn’t advise any change in action, you’d should complete the course of antibiotics as directed. Failure to do so helps breed antibiotic-resistant pathogens in your own body, and you really don’t want that.

You’re sick, infected with something; of course you’re tired; no antibiotic will miraculously cure you in 24 hours.
posted by SaltySalticid at 3:05 PM on January 18, 2019 [8 favorites]

Best answer: I'm with SaltySalticid.

You very well could be experiencing a Herxheimer reaction, which is very common with established spirochete infections.

The Wikipedia article I linked does not specifically mention fatigue and exhaustion, but every website I looked at discussing Herxheimer's and Lyme disease, which is an infection with a spirochete, mentions fatigue first or second.

And it is a sign that the antibiotic is working, because the reaction is ordinarily attributed to endotoxins which are released when the spirochete dies.
posted by jamjam at 3:46 PM on January 18, 2019 [9 favorites]

Best answer: Is this like the five-day Z-pak? Antibiotics in general knock me out for a couple days, but azithromycin knocks me flat on my ass. It's worth it to me because I start feeling better within 36 hours, whereas with amoxicillian might take four or five days before I really start feeling better. It's a powerful drug killing the shit out of your infection.
posted by Eyebrows McGee at 3:55 PM on January 18, 2019 [3 favorites]

What are you taking it for, how were you directed to take it, and have you been taking it according to directions? Your question kinda makes it sound like you took one dose almost three days ago and that's it, which I would not expect would do much of anything other than contribute in a tiny way to the evolution of antibiotic-resistant bacteria.
posted by Anticipation Of A New Lover's Arrival, The at 7:18 PM on January 18, 2019 [1 favorite]

Sorry, one day ago.
posted by Anticipation Of A New Lover's Arrival, The at 7:20 PM on January 18, 2019 [1 favorite]

Response by poster: It helps to know that I may be feeling this bad because the antibiotic is doing it’s job. Thank you for that information. I have been taking the medication exactly as prescribed and am two doses in. I am not stopping it unless my doctor tells me to. I would still appreciate hearing about anything that’s been useful in combating fatigue that can accompany antibiotic use.
posted by mermaidcafe at 7:04 AM on January 19, 2019 [1 favorite]

Honestly, napping. You're tired! You gotta rest! There's no magic cure for exhaustion besides rest. Curl up in bed, feel miserable, watch some cheesy movies, sleep, read a trashy book, sleep, repeat until you feel better. Eat good food, stay hydrated, and rest rest rest.

Probiotics and/or yogurt may help with possible diarrhea side effects, so I'd probably keep taking a probiotic. Some doctors think probiotics might help with exhaustion by replacing your gut bacteria a bit faster, but a Z-pak is such a short timescale I'm not sure you'd notice.
posted by Eyebrows McGee at 8:39 AM on January 19, 2019 [4 favorites]

Eyebrows' anecdote about greater exhaustion from Azithromycin than other antibiotics is especially interesting in light of all the attention it's getting very recently as a potential anti aging drug:
Genetic experiments that eliminate "senescent" cells – older cells, which lose the ability to divide – have already been proven to alleviate age-related dysfunction in model organisms.

Now, scientists have shown for the first time that an FDA-approved antibiotic – Azithromycin – can effectively target and eliminate senescent cells in culture.

Publishing in the journal Aging (US), a team from the University of Salford's Translational Medicine Laboratories compared the effects of a panel of FDA-approved drugs, on i) normal cells and ii) senescent cells, derived from human skin and lungs.

At a single low-dosage, Azithromycin was shown to effectively kill and eliminate the senescent cells, with an efficiency of 97 percent.

Moreover, the normal healthy cells thrived in the presence of Azithromycin.

"It was an astonishing result, and one that got us thinking about the implications for treating or preventing a variety of ageing-associated diseases," said Professor Michael P. Lisanti, the research lead.

"Azithromycin is a relatively mild antibiotic that has been proven to extend lifespan in cystic fibrosis patients by several years.

"Originally, the thinking was that Azithromycin is killing harmful bacteria in cystic fibrosis patients – but our tests now shed a new light on what might be actually going on.

"Our new interpretation is that the antibiotic is probably eliminating the "inflammatory" fibroblasts, in other words, the senescent cells that are normally associated with ageing.

"If that is the case, then we may have unearthed a very inexpensive and readily available method of eliminating ageing cells that are toxic to the body."
If it's killing a bunch of your own senescent cells as well as bacteria, that might indeed be more fatiguing.
posted by jamjam at 3:42 PM on January 19, 2019

As Eyebrows says, the true cure for exhaustion is rest. You can try to drum up extra energy with coffee, etc. But you are taking out an energy loan you will need to pay back. Resting while recovering from an infection will let you get back to normal much faster than pushing yourself too hard and continuing to feel like crap for many extra days.

Make sure you are getting plenty of fluids and electrolytes. Take a good probiotic after you are done with your meds. But please rest and let your body heal!
posted by ananci at 8:38 AM on January 20, 2019 [2 favorites]

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