Bacterial Infections, Antibiotics, and PEGASYS ?

Is there a web site that may have info about taking Antibiotics while on Pegasys/Copegus? No one I've contacted seems to know.
I have contracted a terrible sinus infection and first called Pegasys. They have no research data about antibiotics in combination with their tx. How bizarre is that? Yet, they told me my GI should be able to advise. I called them. They won't advise about any other problem not directly related to my liver.  So...I called my GP and they just simply don't know whether there might be complications from the drug combination or not. Once again, I'm counting on the experience of you guys and gals to help me out if you can.  
My main questions were...
Are there any antibiotics that can be safely used for my sinus infection that won't compromise my Hep-C tx?
I've had success with Amoxicillin and Amoxil in the past for this but don't have enough info to help my MD make a decision. I'm too far along to think about stopping tx now. Five weeks left!
Also, anyone ever heard of taking "Colloidal Silver " for infections, and how well can a damaged liver handle that?
Thanks for any and all suggestions!
Tosser

[MichaelT]

The doc should weigh the meds against the condition of your liver, but generally, antibiotic use is a pretty normal occurrence during treatment.

I've found no interactions with INF/Riba and Amoxicillin in any drug guide.

Colloidal silver has been shown to kill bugs in a petri dish. It hasn't been demonstrated to be effective in the human body against infections. The current resurgence and hype of this stuff has sucked a lot of money from desperate people. People who consume this stuff also risk turning blue permanently - search the web and check out some of the pictures, very scary.

God bless!   -Michael

[raheem]

I've been on Cipro the whole time, 25 weeks now, no infections, no side effects from Cipro.  My WBC is 1.2 and my ANC is 576.  I think the Cipro gives me a little wiggle room.

[oldhippiechick67]

All I have heard is colloidal silver isnt good for the liver...that it can collect in there.   Type it in on the following sites:

http://www.fda.gov/default.htm

www.quackwatch.com

http://www.truthorfiction.com/

I dont know if it is just another big $ making rage, like sea silver, coral calcium, noni juice, etc.  

[GI.PA]

I know of no problems in general needing to use antibiotics while on treatment but your doctor and your pharacist are the best people to ask.

GI.PA

[berlynn]

Hi, I noticed that your WBC was 1.2, are you taking neupogen?
      Thanks, berlynn

[raheem]

No, I am not. My GI doctor treating me is reluctant to prescribe Neupogen for the low WBC and ANC because oncologists tell him there is a concern about long term risks such as leukemia. The Cipro does provide me with a bit of a cushion.  I know a lot of folks are on Neupogen and I asked him about it a couple times but he believes the risks are not worth the benfits.  He may be ultra conservative or cautious, I don't know, but I have to rely on his knowledge to a certain extent.

[susan400]

I've posted this question several times already and can't seem to get anyone to comment on it.  Has anyone had any problems with their sores healing?  Or injection site reactions.  I've had a bad problem with some sores that developed on my belly, one the size of a quarter and the other the size of a dime.  My doctor feels like I've got some tissue damage that developed.  It's very painful.  It's been going on for a month.  He also is ordering a herpes titer to see if maybe there's some kind of herpes going on there (like a shingles type).  Although, I've already had shingles before about 15 years ago and back then, it was on my forehead.  I'd like to hear from others who have had healing problems, or from G.I.-P.A.

Susan400

[oldhippiechick67]

I am not a dr, as you well kno, but the shingles usually pop up on the trunk, front abd and back, shoulder area, I have never heard of it on just the forehead.  Maybe you were misdiagnosed.
Also it usually strikes older people....here is a quote from NINDS site:

Synonym(s):  Postherpetic Neuralgia, Herpes Zoster
What is Shingles?
Shingles is an infection caused by the varicella-zoster virus, which is the virus that causes chickenpox. Shingles occurs in people who have had chickenpox and represents a reactivation of the dormant varicella-zoster virus. The disease generally affects the elderly, although it occasionally occurs in younger and/or immunodeficient individuals. The first sign is usually a tingling feeling, itchiness, or stabbing pain on the skin. After a few days, a rash appears as a band or patch of raised dots on the side of the trunk or face. The rash develops into small, fluid-filled blisters which begin to dry out and crust over within several days. When the rash is at its peak, symptoms can range from mild itching to extreme and intense pain. Contact with a person with shingles may cause chickenpox (but not shingles) in someone who has never had chickenpox before.

I have had troubles with sores not healing fast since on tx, but none are painful. Hope you find out what it is and get healed!  OHC

[Indiana]

Basically you can take most any of the mainstream antibiotics to combat infections. They do not directly affect your tx.
BUT....
You need to realize hoe antibiotics work. They will kill bacterial infections.....but they will also kill off all your good immune stuff too.  The bottom line is that your white counts will probably drop. Many of us are already riding the borderline with our ANC and/or white counts. Don't be surprised if this drops them down even more.
Having said that....you need to kill the infections more than you need to worry about your white counts. With our immune systems already so low we just can't always fight off these infections on our own. Your system can't stand the stress of fighting an infection for long while on tx. I let a little cough go and it turned into pneumonia! Even though the aftermath of taking antibiotics may require you to take Neupogen or reduce your Peg dose temporarily, it's more important that you kill that infection now. I had a temporary reduction of my peg for 4 weeks at 8 months into my tx and I cleared just fine. If you let that infection go it may progress to something worse and take you off of your tx altogether. We don't want that!
My advice would be to take care of that infection NOW and deal with the counts later ....if you even need to.
Good Luck.........

[susan400]

Old Hippie Chick,  Just to let you know, what I had back 15 years ago on my forehead was definitely shingles.  They ran a test back then called a Herpes Zoster titer and it was positive.  Supposedly, you can get it anywhere in your body where there is a nerve line and there is one that runs along your forehead.  In my case, the shingles came down so far that they swelled my right eye shut.  I was diagnosed not only by my physician but also by the emergency room doctor.  Anyhow, I was only 28 at the time, so my immune system must have already started having a problem even back then. But, right now, I'm having these sores on my lower left abdomen.  I am not sure what they are caused from.  My doctor feels it also can be an injection site reaction and that the tissue could have been damaged.    Thanks for replying though.   Susan400

[pjxak]

My husband had herpes zoster when he was 30.  It appeared on the fifth optic nerve which is on the face and the concern was it affecting his eye.  It went from his forehead down his nose.  Not a pretty site.  Just chiming in... pj

[jamit_a]

Hi, I've been on antibiotics twice since I started tx and I had no problems. I'm going on shot 17 this fri and I'm undetectable.
I would follow up with your regular MD or Internist. He or she should be able to advice you on weather or not to take antibiotics while on tx. You may also call your local Pharm. and ask them as well.

Good luck and be well,

jamit_a

[berlynn]

Hi Indiana, I haven't seen you post very much lately. I hope everything is OK with you, emotionally as well as physically.I miss hearing form you. I miss your humor. You were one of the few who did not mind my asking a personal quest. Remember me asking where in Indy you are from as I am from there too. You were quick to respond and supportive and that meant alot to me. Your descriptions of home brought back alot of memories and fond thoughts. I will always appreciate your frienliness. I know that some are threatened by being too personal and I understand that, but I'm the type that needs to hve that connection to others, as you one said,  I'm such a mom. Thanks again for everything and keep checking in to let us know how you are.      Yake care, berlynn

[DonL]

I put the topic in the Comment to column since the thread is getting a little long. Hope that's OK.

I am on week #6. I am slightly anemic (hemoglobin 11.5, down from 16.4 at start and hemacrit 34, down from 47). I have been using flonase for a cough. In the past three days, I have had 3 nosebleeds, each from sneezing. Totally unusual for me.

Does anemia affect the clotting? The flonase sx is nosebleeds, so i have stopped using that.

[Bodie]

I have been on Penicillin for a week for a bad tooth and have had no ill effects. I have talked to the dentist, my liver doc and my GP and we all agree that the infection in the teeth can bring down my immune system and that could be the reason that I have low cbc, even while not on tx. I got a shot of Neupogen a week ago last Tues and it started me on a raging teeth-ache. We figured that my system was so low that when I got the shot, it started the tooth-ache because my system was too weak to fight it. The way your body tells you there is something wrong sometimes is pain and there was not enough wbc to tell my body that something was wrong. That's my theory anyway.
They had no problems rx'ing the Penicillin. It was either that or let the infection get into the bloodstream and no one wants blood poisoning, especially in the head. That goes for sinuses too.
Get a simple a-b and take it on schedule so it will be effective.
I feel better since I got the shot and the a-b's. I get the tooth out tomorrow
Good Luck
Bodie

[willing]

Hi - I hadn't replied earlier because my symptoms are somewhat different - but yes I also have problems with open/slow-healing sores. No problems at the injection site but lots of minor cuts, mostly on hands and feet, as wells as mouth sores, that either don't heal or take forever to heal. The IFN-induced psoriasis leaves patches where the skin just falls apart and then doesn't heal. I'm attributing the failure to heal to the low neutrophil count (ANC ~600). The only thing I've found that helps is topical antibiotics and patience. Best wishes.

[bwave]

Tosser, I have had a lot of all sorts of Infections since begining tx. I have been on a few antibiotics lately. I can't remember the name of the one but It was the 5 day antibiotic. Now I am on a 10 day tx and It's called Levaquin 500mg. I have had no probs w/them at all. My Dr has this Medical PDA that she cross refrences EVERYthing she prescribes for me to make SURE It won't cause any trouble w/tx or my liver. I think she bought the PDA just for me:) J/K. Take care, Kelly.

Berlynn & Indiana, I live near S.B. Either one of you near there?
Just wondering:) Take care, Kelly.

DonL, there Is a lot of sinus Infections/flu going around. The sinus Infec starts out there, then you get a sore throat/ear ache and cough. The sinus Infec will make your nose bleed. Low platelets will also make your nose bleed. How are your PLT? Mine are very low and It caused me to have a slight nose bleed for 2 weeks. Now It's just on and off bleeding. Peace, Kelly.

[oldhippiechick67]

yes anemia can cause bleeding probs, and tx often causes lower rbc's and low platelets, which are needed for clotting.  Nosebleeds and dry sinus membranes & nasal sores are common on tx.    OHC

[Indiana]

bwave....I live outside of a the little town of Zanesville in northern Indiana...just south of Ft. Wayne. Just far enough from you to avoid the lake-effect snows of lake Michigan.

Berlynn...Thanks for the kind comments. I'm always around to try to help. You can always e-mail me at ***@**** if you just want to chat about stuff.
I have been really busy lately with the kids and Marching Band. They go to a little high school here populated mostly by farm kids. They have one hell of a Marching Band though. They took 3rd in the State finals last month, then moved on to the Bands of America contests held every year in Indy at the Dome. Last weekend were the finals.....THEY WON!!! They are now the NATIONAL CHAMPIONS in class A(small schools) for the whole USA!!! The whole weekend was AWSOME!! I rejoined the Pit Crew this year after I finished my tx. I assist by loading & unloading the SEMI full of instruments and props and I get to run out on the feild at each performance and set up those props. I was there in my Elvis outfit doing my best to embarass my daughter who is a senior ColorGuard captain. I succeeded! I had a BLAST!! It's GREAT to be done with tx and able to get back into living again. I give inspirational speeches before every performance and cheer them on at every contest. I use my tx experience to help show them how to fight against ALL odds and how keeping a positive attitude can really pay off. I have a LOT of believers now!
Now it's on to winter Drumline. I think my youngest(14) may get involved in that.
So...I'm just really enjoying being around all these kids. It keeps me feeling young and thankful for my health.
I'm not a real religous person but I really believe that God had a hand in all this and is using me to help teach these kids about believing in themselves and to show the adults that HCV isn't something to be afraid of but rather something to be conquered. They all watched me go through my tx and saw how hard I fought for my life. Now they see how perseverance can pay off.
As a type 1b I had the worst "odds" of all....what a load of ****! Odds Schmodds...It CAN still be done!
  Keep your eye on the prize. Life is GOOD on the "Other Side".............

[DonL]

Thanks. I had the cough before I started tx--in Sept there was a bug going around my office that started as a sore throat and progressed to a long-term cough. However, mine is lingering so the riba cough may have taken over. My PA did suggest a DM cough syrup, which I have been using sporadically. My house is 200+ years old and there is a wood stove in the kitchen, so dust is also a possiblity (I cough more in the evenings). No nosebleeds today so it might have just been the flonase.

My PA reminded me that when you're under tx, you think everything that happens to your body is caused by the tx and things you might have ignored suddenly seem important. Anyway, thanks to all for your advice.

[DownThisRoad]

I took levaquin for 9 days (around my 13th week of tx) because I had a huge sinus infection.  I've had sinus surgery 2 years previous from starting hepC treatment and suffer with my sinus.  The levaquin cleared up my infection however, a CAT scan shows that it would be wise to have sinus surgery once again.

I am holding off on the advice of my ENT as well as GI to not have surgery during my treatment meds.  The levaquin, I was told by Pegasys, my primary doc and GI is safe to take for infections while on the combo therapy for hepC.

I am clear (undetectable) of the virus and approaching my 30th week of treatment meds.  I will do 48 weeks of the hepC meds and possibly an extra 4 - 6 weeks after the usual 48 week recommendation for 1a genotypes.

[MajNeni]

Hey, Indy, thanks for another transfusion of cheer.  CONGRATULATIONS to your kids!  What a triumph!  Wowwee!  Sounds like you've found the silver lining in this HCV/TX experience.  Sounds like your daughter is almost ready to leave the nest; better put a rock on the little guy's head.  They chose their parents well.

DonL,
Lots of things can cause the nose bleeds, as suggested already.  Low Humidity is definitely also a possibility.  Lubricating inside your nose (I'd suggest Vitamin E oil) might help.
  
If your cough is not connected to any infection, it may be the dreaded RIBA COUGH.  My best rec for that is a single ingredient Cough Suppressant: DextroMethorphan Hydrobromide.  It relaxes that spasmodic cough reflex; it's otc, and the pharmacy may have a store brand.  It will help you (and your housemates) relax and get sleep.
If you are coughing up stuff, Guaifenesin is an expectorant (helps to loosen the stuff to bring it up).  If the stuff is thick, streaky and opaque, especially yellowish or greenish, that's a sign of infection, and you should see your doctor.  
I had horrible cough, even got chest X-ray, and nothing else was wrong, so it was Riba cough.  It was bad in the first months, but disappeared at some point - maybe 4 months into tx?

Maj Neni

[MajNeni]

What you described with your feet sounds like Plantar Fascitis.  Check it out.  There are some good things you can do to help it, such as stretching excercises.  Cortisone shots help, but they're not too good for the liver.  Anyway, I don't think this one comes from HepC!  Best, MN

[Tosser]

To: Indiana, Oldhippiechick, Michael, Raheem, Erin,
Jamit, Bodie, Bwave, and Downthisroad ...
Thanks so much everyone,
for comments on my latest health emergency. Once again, the support I got here led me to recovery. I saw my GP and he put me on Zithromax, a strong five day antibiotic. The doctor said it wasn't a matter of choice. I had it bad enough that the infection had to be stopped, but since my last visit and lab work he put me on a low carb diet and said my blood sugar numbers were low enough now that we may wait a while to do any further testing. I told him that was fine with me and that I felt that all my lab numbers would probably be closer to normal by around next March, six to eight weeks post treatment. I'm already feeling better, but still run out of energy pretty quickly during strenuous work. That's normal I think. I have to very soon deal with the neuropathy in my feet again. Terrible pain in both heals after standing for long periods followed by numbness and tingling while at rest. So bad I can barely stand on them first thing each morning, but I hope they too start recovery after tx.
Thanks so much again to each and every one of you. You guys are the greatest and I am always proud to be a part of this family...even with the roudy ones! ;o). Keep the love and sense of humor about life, and may God bless you all with good health!
Tosser

[MajNeni]

check this site:
http://www.foottalk.com/heelpain.htm
There is a good link to a page of helpful exercises.  Wearing good shoes also helps; if your shoe heels are worn down on one side, they'll make the pain worse.  Walking shoes and cross trainers are good.
Maj Neni

[Tosser]

Hi Maj!
Thanks for the link. I've seen a few foot specialists and a pain specialist and they tend to agree with you somewhat because of the symptoms being so similar to Plantar Fasciitis, but having been diagnosed with Hep-C and High Blood Sugar after injuring both feet a year and a half ago, and spending six weeks in physical therapy to no avail, I'm pretty sure that my feet are unable heel up under my present health condition. One of my doctors noted the presence of sensations that are associated with neuropathy that can occur in Diabetes patients, although he was inclined not to make a final conclusion. I have also seen medical reports that revealed similar patient accounts of neuropathies associated with Hepatitis-C and other liver disorders.
Therefore, my road to physical recovery may parallel my Hepatitis recovery...hopefully.
Tosser

[berlynn]

It's already the 24th and I have taken a few days away from the computer, been way to busy. I hope you scroll down this far, if not I'll look for your future postings. I am from outside of Indpls. Although my family still lives all over IN, I moved to AZ after my first baby was born in 1980. I still go home to visit when I can, but of course everything has changed. My parents come out and winter here with us. I can't wait to see them in Jan. I was home last June, my second and third week of tx. I love and miss Indy, but I also enjoy livin in the desert. It's supposed to be 75 on Friday and I'm trying to talk my husband into going fishing. I've never been to SB but I'ldefinately be sending prayers and warm thoughts your way.
                                                     berlynn

[berlynn]

Hi, it sounds like you've been very busy, I'm glad that everything is OK. It sounds like you have some talented kiddos. I sure don't know what I'd do without mine right now. They sure give you lots of good reasons to keep on goin on. How far are you post tx? Have all of the nasty sides gone away yet? Thanks for your address and support. You can also get in touch with me at ***@****. I don't always check my mail everyday though. With the holidays, kids, and grandkids life gets busy, as you already know. I've been trying to focus more on these blessings lately instead of feeling sorry for myself and giving in to the sx. Are you guys going to have a white Thanksgiving this year? Enjoy the holidays and keep in touch and thanks for being there.       take care,    berlynn