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Asthmatic on Clarithromycin for chest infection and vaginal thrush

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Currently taking flixotide (1 puff) and ventolin (2 puffs) immediately before bed. I started on this treatment about six days ago. I do not use either flixotide or ventolin if I am not unwell.

I've been taking Clarithromycin 250mg, 1 tablet twice a day for five days now. There are 14 tablets in the course. I woke up this morning with vaginal thrush (this is my first recurrence, last infection was over five years ago.

The clarithromycin doesn't appear to be working. I still have a very congested chest and I completely lost my voice within 24 hours of commencing this course of antibiotics. I've been taking them for five days now with no visible improvement. My voice has come back at about 50% but it is incredibly nasally and I still have a horrible cough.

Can I take clotrimazole with clarithromycin? Can you recommend another antibiotic to clear up this chest infection?

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 23 Doctors Online

Hello,

Thank you for asking your query at DoctorSpring.
Since you have a history of Bronchial Asthma with previous history of chest infection, I trust your judgement on possible chest congestion and infection.
If the infection is indeed caused by a bacteria (which also has caused laryngitis) Clarithromycin should be effective. Since there is no response to Clarithromycin a viral infection should also be considered. As you might be aware hoarseness of voice is a well-documented symptom of GERD also (in addition to laryngitis). Allow me to list down my recommendations for clarity.

1. If the symptoms are not very troublesome you can continue clarithromycin. You can step up the dose to 500 mg twice daily for 10 days in total. Changing the antibiotic in mid-way might result in emergence of antibiotic resistance, which is better avoided in your case. The usual respiratory bacteria are susceptible to Clarithromycin in general. So it could be that the anti-bacterial effect is just kicking in, or it’s not a bacterial infection at all.
2. If you has to change an antibiotic I recommend a Cephalosporin like Cefixime 200mg twice daily for 7 days rather that Clotrimazole
3. Do take steam inhalation twice a daily . Also warm saline gargle. This is very important in reducing the congestion
4. Also add an anti allergic medication like Cetirizine or Allegra twice a day.
5. You can continue the MDI (inhalers)
6. A PPI - Like Omeprazole or Pantoprazole can be taken just before sleep ( not with food) once a day for GERD. This might surprise you by relieving the hoarseness
7. We do not offer prescriptions, so please take the medication in consult with your Doctor.

Hope this helps
Please feel free to ask followup questions / clarifications
Thank you


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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