Labriola L, Jadoul M, Daudons M, Pirson Y, Lambert M. Division of General Internal Medicine, Cliniques Universitaires St. Luc, Universit� Catholique de Louvain, Brussels, Belgium.
The authors report the case of a 45-year-old woman admitted for pneumonia who presented anuric acute renal failure after 12 days of intravenous amoxycillin-clavulanate treatment.
Acute renal failure resolved rapidly and completely after antibiotic withdrawal.
Analysis of the first post-anuric urine specimen showed many crystals.
Infrared spectrophotometry revealed that the crystals were composed of trihydrated amoxycillin.
The possibility of intrarenal obstruction due to massive drug crystalluria should not be overlooked in the face of abrupt anuria.
PMID: 12834178
1: Presse Med. 2000 Apr 8;29(13):699-701.Links
Acute renal failure after amoxicillin crystallization
Boffa JJ, De Preneuf H, Bouadma L, Daudon M, Pallot JL. Service de R�animation polyvalente, H�pital Intercommunal Andr� Gr�goire, Montreuil.
BACKGROUND: Drug-induced nephrolithiasis is a rare finding, especially with beta-lactamins. We report a case of acute renal failure due to amoxicillin crystallization.
CASE REPORT: A 48 year-old woman was admitted because of pneumococcal meningitis. After 4 days on high-dose amoxicillin (320 mg/kg/day), she developed acute oliguric renal failure and amoxicillin crystallization was documented by infrared spectrometry.
The outcome was favorable after amoxicillin dosage tapering, together with one single hemodialysis session and further hydratation.
DISCUSSION: Amoxicillin is mainly excreted in the urine in its unchanged form.
The risk of crystalluria is increased by low urinary pH, low urine output and high-dose of the drug.
Such a crystalluria should be accurately identified by infrared spectrometry.
PMID: 10797821
Posted by CaliforniaLyme (Member # 7136) on :
1: Ann Biol Clin (Paris). 1985;43(3):227-31.Links
Aminopenicillin crystalluria: identification by infrared spectrophotometry
Moesch C, Rince M, Raby C, Leroux-Robert C.
Renal stones and crystalluria can be characterized unambiguously by global physical methods.
The authors report four cases of crystalluria induced by aminopenicillin (ampicillin and amoxicillin).
Identification of these drug-induced crystalluria was made by high-pressure liquid chromatography and infrared spectrophotometry.
The physico-chemical data and infrared absorption characteristics can give us diagnostic for various forms of ampicillin and amoxicillin.
PMID: 4025964
Posted by h8lyme (Member # 11765) on :
what do you consider high doses? I was on 3000mg/day for 3 months. I've heard people take up to 6000mg/day.
Posted by map1131 (Member # 2022) on :
I did 3000 mg a day with 200mg of doxy in the early stages and it didn't nip anything in the bud. Everyone is different.
Pam
Posted by sixgoofykids (Member # 11141) on :
I was on 2500 mg three times daily along with Probenecid and other meds. for five months.
It was a hard drug for me as every time I increased the dosage I would herx again. I made progress on it though ... I was glad when we finally changed to another med.
Posted by improver (Member # 8380) on :
I did 3000mg per day for 6 months and just stopped a few weeks ago, but I was definately making progress on it. I stopped due to slow heart rate and pain in the gallbladder area just in case they were related but I don't think they were.
I might ask my llmd if I can go back on or try IM Bicillin.
Posted by lpkayak (Member # 5230) on :
well-i posted this a long time ago. i think everyone thinks i did the math wrong...but i didn't.
i took 17,500 mg of amox (10 875 mg in the morning and 10 at night) along with 1000 mg of zith for about a year. after that i switched the zith to biaxin and pulsed for another year.
i got about 80% better. my fatigue went away and stayed away. the ball of the foot pain that was really severe went away. my thoracic back pain also went away.
i had a few good years, but my arthritis has continued to get worse and the less i can move to exercise the more systemic problems i have. its hard to tell what is from lyme, what is from the treatment and what i would have had anyway.
i thought the persistant reflux was from the abx but my primary said it is probably from the ibuprofen i need to take in order to walk.
i do think the abx gave me my life back and made it possible for me to work long enough to the kids thru college. and they didn't kill me. but i don't know how much damage they have done to me.
good luck.
Posted by gambler (Member # 8441) on :
I take 7 grams a day. It has either really helped, or doesn't work at all, because I am not herxing anymore and feel better all the time.
I have been on it for 6 months, was on IV for 9 months before that. I almost think this has helped more.
Just need to get rid of night sweats. constant tingling, and migraines and I will be better than my old self.
gambler
Posted by Lily (Member # 13158) on :
I took 4000 mg/day + doxy. All symptoms went away. I'm not sure if it was the amoxy or doxy.
Lily
Posted by wiserforit (Member # 9732) on :
Hi --
I'm taking 876 mg. X 6.5 pills a day and hope to work my way up to 8 pills. I herx like crazy with every 1/2 pill increase. Been on Amox for 9 months.
I'm also taking one Malarone daily and 125 mg. Zithromax every third day.
I was feeling much stronger on the Amox by itself, but am trying to address Babs. The little amount of Zithromax always packs a whallop.
I, too, feel better on the Amox than the IV Rocephin; but that may be because the Roceph knocked the germ load down.
I'm just now starting to have some GERD issues.
Best to all,
wiserforit
Posted by perplexed (Member # 1913) on :
I just came off amoxicillin for 10 days for a strep throat. I was taking 875mg twice a day. I became so ill that I was in bed most of the time. My body ached horribly like when I first contacted Lyme Disease in 1972.
I had headache, nausea and low grade temp. It made me feel worse than the strep throat did.
Could this have been a herx?
Hugs, Perplexed Posted by CaliforniaLyme (Member # 7136) on :
I am on 4500 a day!!! 1500 3 times daily!!!
Have been for over 3 years now!!
Posted by perplexed (Member # 1913) on :
Wow!! California Lyme!! That is alot of amoxicillin...I would still be in bed. That stuff is nasty.
Hugs,
Perplexed Posted by Vermont_Lymie (Member # 9780) on :
Hi, I was on over 10 grams/day of amoxy for many months; worked up to 12 X 875mg/amoxy (split into morning and evening doses, six pills at a time).
It helped alot. I was on high dose amoxy for over a year total, but ultimately felt like I wanted to try other abx due to resistance of some specific neuro symptoms.
Take lots of probiotics with amoxy, and be careful with diet and yeast. It certainly assisted my on going recovery.
Posted by CherylSue (Member # 13077) on :
I tried amoxicillin on and off for two months. I was supposed to take 4000 a day, but only made it to 2000 a day because of the herxing.
My LLMD then switched me to doxycycline this past month, and I tolerate it much better than the amoxy. I'll let you know in the next month if the doxy works.
CherylSue
Posted by CaliforniaLyme (Member # 7136) on :
Hey Perplexed- it is funny how different we all are- I don't have any side effects at all and don't notice any taste from it even- it just keeps me normal- and asymptomatic while I breastfeed my little one-
Posted by jamescase20 (Member # 14124) on :
I got severe pains in my butt on amox...dont know why, but I switched to plain old tetra and the pains went away within a day. Amox sucks...I think for lyme...but thats all I had while waiting for a diag from the lab.
Posted by charlie (Member # 25) on :
...I tried all kinds of doses of amox....Sarah's dose of 4500 seemed the most effective. Above that didn't do anything better...below 3000 was much less effective.
Charlie
Posted by Areneli (Member # 6740) on :
I wrote about it before on this board. If you use search option perhaps you can find it if moderators didn't remove these old posts.
About two years ago I tried high doses of amox (+ some Flagyl).
3 g of amox per day was my starting point, after that I have increased the dose by 1.5 g every week. I did herxed after every dose increase like they say it in The Book. Started herxing about 70 hours after each dose increase.
So the following week I was on 4.5 g/day, later on 6 g/day and so on.
Eventually I hit doses of 27 g/day (twenty seven grams per day) without any ill consequences to myself.
It helped me but didn't cure me. I went later to tetracyklines and started herxing again.
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