Antibiotics with MVP

[Lori-T]

  Dear Doctor,
  I have a question regarding MVP.  I was diagnosed with MVP with slight
  thickening and trace regurgitation and possible slight aortic valve
  thickening.  I was told that I need to take antibiotics before dental
  work and any kind of surgery.  I would like to know what else I would need
  to take antibiotics for.  Is these a web site to go to that lists the
  recommendations.  For example, if you go to a doctor and get a (I am not
  sure how to spell this) nasocopy (where they insert a thin tube (with
  laser) down your nose, or when you go to a gastrointerologist and in his
  office he needs to use a rectal scope, or if you get your legs or armpits
  waxed (I know this sounds stupid - but I just am not sure and do not
  want to take chances).
  Recently I had to get minor skin surgery and was medicated.  I am knew
  to this and called the cariologists office to get a perscription.  I told
  the nurse that I was allergic to Ceflex (I am not sure if it spelled this
  way or Keflex (a cefolasporin))  so that I don't think I could take
  Amoxicilan.  I told her for sinus infections (which I get alot) I ususally
  take Biaxin.  So she called in a perscription for Biaxin of 4 (four) 500 mg
  stregth to be taken one hour before the appointment.  I took the four and
  got deadly ill.  I felt nausea, dizzy, severe stomach pain and chest pain and
  felt like I would pass out.  I spoke with my cardiologists associate and
  he told me that the dose was incorrect.  That I should have only been given
  one Biaxin (500 mg) not four.  Could you please let me know first is this
  correct one Biaxin will do the job, and the second thing is that I felt
  like I was poisoned.  Could this dosage have done anything to my internal
  organs.
  Sorry for such a long message.
  Thank you so much for any insight.
  Lori T

[CCF CARDIO MD APS]

_
Dear Lori,
Prophylaxis for bacterial endocarditis (i.e. taking antibiotics prior to a procedure to avoid infection of the heart valves)
is recommended for any dental, oral, respiratory tract, gastrointestinal, and or genitourinary procedure.
There is no evidence that waxing hair of the armpits or legs results in transient bacteremia (bacteria in blood) and therefore it is not necessary to take the precaution.
Just because you have an allergy to cephalosporins, this does not mean you are allergic to penicillin and amoxicillin.  Clarithromycin is famous for the gastrointestinal side effects that you experienced, and not surprising given the large dose that you took.
Although you may not have any such effects if you take the proper dosage (500mg, one pill 1 hour prior to the procedure), you may want to try the well tolerated azithromycin- one 500mg pill 1 hour prior to thr procedure. Just so that you know, the recommendations are for higher doses in the case of genitourinary and non-esophageal GI procedures.
It is highly unlikely that the large dose of clarithromycin did any damage to your internal organs as you say,
but if you are still having symptoms of nausea and diarrhea, etc. then you would need medical evaluationof the same and still it is highly unlikely to be related to the dose of antibiotics that you took.
Good Luck and write back if you have any further questions. If you want to know, the article with recommendations for antibiotic prophylaxis was published in the Journal of the American Medical Association (JAMA) in 1997, this is available at any medical library to anyone.)
Information provided in the heart forum is intended for general medical informational purposes only,
actual diagnosis and treatment can only be made by your physician(s).