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This is the question I started this with:

>So many celiacs seem to have problems taking antibiotics -- I can take only
>Bactrim (Septra) and the new faster working Zithromax -- that I wonder why
>a concerned doc, who cared about our welfare, couldn't inject them
>intramuscularly as they used to in the fifties.
>
>When I was young in the 1950's all the antibiotics I took were in the form
>of a shot in shoulder or butt. They worked efficiently and well. I remember
>them as working better than the pills. I never had a bad reaction to them,
>nor did I ever hear of any of my friends doing so. I know some were
>allergic and had very bad reactions, but that can be screened for ahead of
>time.
>
>In the hospital they give antibiotics IV still. Again they seem to work
>well, and they don't seem too concerned with bad reactions. Why not just
>give us a shot and send us home with no messed up GI tract. Or is that too
>easy.

All the comments (except Ed: comments) below this are from listmembers.

Each paragraph is from a separate individual: -vance
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It isn't that easy.  As a veterinarian I know that all antibiotics do not
come in an injectable form,  some are very irritating if given in the
muscle and must be given in the vein, and then there is the issue of cost.
If it is an insurance thing, I am sure they prefer the less expensive oral
route.  And then injectables need to be repeated every 8 or 12 or 24 hours,
one "shot" generally won't take care of the infection at hand.  If it does,
then it probably doesn't need an antibiotic anyway.  Most doctors know that
the oral route has just about as fast absorption and action as starting
with an injection so they avoid the muscle trauma that an intramuscular
injection will cause.  On the other hand, if we (the doctors in my
practice) have a gastrointestinal problem and we need systemic antibiotics,
we will often at least start with in injection because of questionable
absorption or necessary breakdown for absorption or it may be vomitted
before absorption.  Then there are antibiotics that are not well absorbed
and are intended for GI use.  And, of course, there are all of us with our
idiosyncratic reactions to either the antibiotic or the excipients.
Medicine is a science and an art - unfortunately, not black and white and
it doesn't always follow a script.  But, it always helps if you are able to
communicate with your health care giver. <> Ed. note: I communicate well
with him, it just that he doesn't communicate much with me :)

I have a port inserted under my shoulder for i.v. magnesium, since I am
unable to take enough by mouth.  My doctor uses the i.v. method for
antibiotics with far fewer side effects than when I took them by mouth.  I
used to ask for the injections, but found that few dr.'s offices even stock
them anymore and rarely use them - even for Strep.  Could it have something
to do with the exorbitant costs of the new antibiotics?  AM I being cynical
or do the drug companies influence the "RX of choice" so much that the
doctors' but into oral meds exclusively?  I have had allergic reactions to
penicillin and tetracycline, but they were to the oral meds.

FYI, you can still get antibiotic shots at the doctor's office.  My older,
non-Celiac son won't take medicine by the mouth (he has autism and can't
stand the taste of medicine), so the doctor gave him an injection of
antibiotics last time he had an infection.  Believe it or not, my son was
thrilled to get a shot instead of medicine!  Anyway, it seems to be available
by request but it's extremely expensive.

I specifically asked my son's doctor why she couldn't inject him with
antibiotics when he had a very bad ear infection, I had just heard of a new
injectable children's antibiotic out on the market. Her reply was that the
shot is very very painful, because it is injected into muscle. my advise is
to ask the doctor for the injection! they think they are saving us from
pain when in fact it would be better for us.if your doctor has other
reasons then he will share them with you I am sure.

Hi Vance! I just read your posting. You mentioned that in hospitals they
"still" give IV antibiotics. There are several good reasons for that: many
infections can be life-threatening and if they weren't given IV (thus
getting to the infection quicker) the patient could very well die. Also,
many of the powerful new drugs are not available in any other form than IV.
With many people needing to leave the MD's with a prescription, even for a
cold (which is viral), the germs are mutating and developing resistance to
the older drugs. I know it doesn't make it any easier for a person with CS,
but those are several reasons  why hospitals give many meds IV.

I have had many operations. They gave me vancocin IV. Never had a
problem with it. But when I had med orally from same day surgery, I had
to take an antibiotic, it messed up my stomach. When I asked why
couldn't they give it to me during the one day stay, they just said, "We
only do that for hospital stays." I guess it is just not included in the
health insurance plan's costs of what they will pay and won't pay for
same day surgery when you go home a few hours later. I remember getting
injections too in the 1950s and it was MUCH better and you got better
faster.

Antibiotic by shot and or by I V can and do give problems, I nearly
died by one given by I V. I had a doc say  you have to be careful no
matter how they are given.

Aside from the obvious benefit to those with CD, injections would also
prevent the unpleasant yeast infections that also accompany antibiotic use
in some people.  I remember them in the 60s.  I got better faster.

   I believe the tendency to prescribe oral medicines is due in large part to
the HUGE pharmaceutical corporations' influence on the medical industry.
After all, they can mass produce oral medicines fairly cheaply, most require
no refrigeration and are shipped easily.  Then they claim they are recouping
the research costs by charging exorbitant prices for the new wonder drugs.

   The irritating thing, most insurance companies would rather cover the cost
of an oral medicine, rather than a shot an a doctor's office.  The last time
I had strep throat (4/98) I made a trip to the emergency room because I was
so sick.  The doctor there prescribed erythromycin.  My  co-pay on it was
$8.  It did absolutely nothing for me, so two days later I called and was
able to get in to see my own doctor.  (Miracle, but was able to do it
because he was the doctor on call for the clinic for urgent cases.  Thank
goodness as I was still so sick then.)  He offered a prescription or an
injection of penicillin.  I took the injection, but when the insurance was
filed, they didn't cover the cost of it, (I think it was $50) when they
would have covered all but $8 of anything else he would have prescribed.

Vance, My husband asked his doc the same question.  She said if it is
injected and you have a reaction, they can't get it out.  With pills if you
have a reaction, you just stop taking them.  I think it is a liability
issue.