I broke a tooth and the dentist gave me an appointment in 10 days, he has told me to take an antibiotic called Amoxiciline,(penicillin) for 7 days,starting today so I will finish the antibiotic three days before my doctor's appointment.
"Amoxicillin should be used with caution in patients with lymphocytic leukemia who are more susceptible to rashes (maculopapular skin reactions).
Do you know anything?
What other antibiotic could I substitute it for?
I called my hematologist, but she is off today, I can't contact her until Monday.
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Is the dentist removing or repairing the tooth, you don’t say. Amoxicillin is the antibiotic of choice for dental work. Looking back with a recent extraction I was given 500mg by the hospital and 15 tablets so would imagine 3 for 5 days.
Hello, I do not know, I did not see my dentist, I'm out of town.
I went to the emergency dentist where I am, he did an x-ray and told me that the tooth had to be removed. I called my dentist, sent him the x-ray and he sent me the antibiotic and an appointment in 10 days.
Do you have a diagnosis/history of maculopapular or other skin rashes?
Remember the drug warnings include every single thing that has ever happened to anyone, that could possibly be traced to the drug. This warning notes that people with a lymphocytic leukemia, are *more susceptible* to them. Not *a guarantee* you'll get one, or a warning to avoid the drug. If something is severe, the literature clearly states "avoid this drug while X (other drug, disease, whatever)".
A rash is not a life threatening side effect, so go ahead and take it but watch for skin things. Takes pictures if you aren't sure. Avoid the sun; I foolishly went sunbathing (much younger of course) once while on amoxicillin and got a rash everywhere except my bikini. Being immune compromised, you probably need to minimize the bacteria in your mouth, before procedures in that area where bacteria from there, can get in the blood. Especially if that tooth happens to be infected.
Call your hematologist if you are concerned, I am sure they will say much of what I told you. If you have a history of reactions to penicillins/amoxicillin, then that is a different story, and you should consult with someone about the risk of this drug versus another.
Someone miscommunicated something somewhere. You got the Rx issued promptly to get it filled/to have it on hand, but you are not supposed to start until 7 days before the procedure, according to what you originally wrote. In my area, sometimes Rx's can take 2-3 days to be filled, even for antibiotics. The delivery doesn't get done (bad weather, people sick), the Rx doesn't get filled immediately, they are closed, etc.
You wrote "he has told me to take an antibiotic called Amoxiciline,(penicillin) for a week before the appointment" so IDK why you started already, that instruction means "start taking the medicine a week before the appointment" so Day 1 of taking it, is 7 days before that date.
Then clarify, because either they wrote the wrong number of pills/wrong number got dispensed, or you were supposed to wait to start.
I am guessing a likely error is 14 days worth was intended, and somehow you got 7. For patients with an actual or suspected infection, I commonly see the prescriber have the patient start immediately, then continue for a few days after the procedure.
Hope you can get a phone call in before your weekend. If it's already the weekend, I would just take the drug through the weekend & get it resolved on Monday. If you are positive the dentist said "start immediately."
Hmmm sounds like your dentist is forgetting your appointment isn't for 10 days. Because I've never heard of someone taking it the way you described, stopping 3 days ahead of the procedure.
If it were me, I would be saying "excuse me, I'm a little confused. You want me to start taking it now, for 7 days, and have finished & been off it for 3 days before the procedure? I've never heard of that, can you explain more? I am being told by others that it's more usual to take it until the day of surgery, if not even longer. I don't understand this protocol. I've read that in immune compromised patients like me, any antibiotic is continued at least through the day of a procedure".
Me being a pharmacist, I would word those sentences slightly differently, but the gist would be the same. A few times when I've questioned a provider on a prescription that "didn't make sense according to previous prescribing practices" I would hear about something new they read about in a journal.
I'm curious as to why your prescription would be done this way, if nothing else lol!
Do you have any symptoms of infection in that tooth/area? Do you have an elevated temp, any lymph nodes that side larger/tender, any aches or muscle spasms or tenderness? Do you feel "flu-y"?
Since your dentist definitely said "start today" if it were me, I would continue it and get it clarified Monday. It shouldn't hurt to have a few days extra of this antibiotic, but stopping then starting is how resistance comes out. It's why on many antibiotics they say to take a dose ASAP if you forget one; trying to keep the blood level high enough to affect organisms.
I'm not sure what you mean when you say "better to stay 10 days until appointment."
When taking antibiotics, it is generally better to not start & stop them. Since that is one way how resistance develops.
Your dentist said "start today". So you started today. Call on Monday to clarify if you truly are supposed to only have 7 days of treatment, stopping 3 days before the procedure. You asked a question here, and got feedback that the "stopping 3 days before the procedure" isn't commonly done.
I've commented on what I have seen done, as have others. But IDK any of your medical history, why you need antibiotics, or what "broke a tooth" is actually describing/what your dentist thinks that means, or why "start today for 7 days before appointment" when the appointment is 10 days out.
I think you should speak with both your dentist & hem/onc.
You mentioned you are out of town, that this is an emergency dentist, They may be just giving you more net in case you fall, especially if you told him you're immunocompromised.
I was given co-amoxiclav, Amoxicillin/clavulanic acid, 3 tablets a day for 5 days starting after the extractions. By day 3 I had severe constipation with overflow diarrhoea.
This was odd as I had Amoxicillin some years ago without any problems. Either it was the clavulanic acid or the Amoxicillin wasn't very effective without clavulanic acid.
I had a root canal last week, and the dentist prescribed Amoxicillin, advising me to start taking it one day before the procedure. I also consulted with my CLL specialist, who confirmed that it was safe for me to take Amoxicillin.
I’ve had a couple of dental procedures since being on Acalabrutinib. In each case, I was told to stop taking the Acalabrutinib three days prior to the procedure and for two days after because of the increased risk of bleeding.
I can’t remember which antibiotic I was given, but I have become allergic to some. As SofiaDeo recommended, just watch out for signs of an allergy. I was given Azithromycin after a root canal and within a day had swelling in my mouth and throat. I stopped it immediately and took a Benedryl, as per my doctor, and was fine. Another antibiotic was prescribed that I tolerated.
My husband, who has CLL, is allergic to Amoxiciline and it does indeed cause him a rash and his face swells so that he looks like an ape (I kid you not), strange thing is, this happened way before he was diagnosed!!! There are alternatives but I can't remember which one he has, your dentist/GP will be able to advise
Amoxiclav is what my dentist prescribes me when necessary. But I don't know why would he prescribe it a week before the procedure. Normally I start taking it after the procedure to prevent an infection.
I have had CLL 7 years with treatment for the last 4 years. In 2024, I had hip replacement, I was given amoxicillin. Now every time I go to the dentist I am prescribed amoxicillin before any procedure even a tooth cleaning. Thankfully no side effects.
FWIW I took Augmentin (which I believe includes Amoxixillin) for 7-10 days recently for a sinus infection. I am on Calquence. No side effects whatsoever.
I have taken amoxicillin several times without any problems, but my doctor does seem to like to give cefdinir more than amoxicillin. I’ve never asked why. I assume it is the type of bacteria that he thinks I have and he is treating.
I had been on Imbruvica 420mg since April 2021, after CLL diagnosis in December 2011. When I went for some gum treatment this year in February, I took amoxicillin 500mg capsules twice a day. Somehow after 5 doses, I had to stop because of chest pains & dizziness and felt sick. My periodontist directed me to stop the antibiotic, and to just wash with some salt water instead. I guess my case is unusual, as I was not allergic to penicillin before. Presumably, you won't have the same trouble as you are younger & stronger.
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