OpenHealth Q&A

Concerns Regarding Clindamycin Treatment for Possible Infection

Greetings, I am a 33-year-old female, standing 5'3" and weighing 113 lbs, with a Caucasian background. I have a medical history that includes ulcerative colitis, which led to a total colectomy nine years ago, resulting in an ileostomy. Recently, I began experiencing significant pelvic discomfort and a decrease in my appetite, which started about two weeks ago (around March 6). I had a consistent pressure and pain in my lower abdomen, making it challenging to eat without aggravating the discomfort. I visited my primary care physician, who conducted a test for a urinary tract infection (UTI), yielding negative results, though my white blood cell and leukocyte levels were elevated. To be thorough, I underwent comprehensive STI testing as well, which also came back negative. Subsequently, my doctor referred me to a gynecologist, and I was fortunate to secure an appointment on Thursday. A couple of years back, I dealt with an ovarian cyst that resolved itself, and because my symptoms seemed reminiscent of that issue, she thought it would be prudent for a specialist to investigate further. I anticipated a complete pap smear during my gynecological examination; however, the doctor performed a manual examination and applied pressure to my abdomen. She concluded that a cyst was unlikely given the absence of abdominal tenderness. Nonetheless, I did experience sensitivity during her examination of my cervix, leading her to suggest that I might have had an infection that is now improving. She noted that if it were a severe infection, I would have exhibited more distress during the examination, but I only felt discomfort. She presented me with two pathways: one involved commencing an antibiotic treatment right away, while the other option was to wait for the results from my scheduled transvaginal/transabdominal ultrasound on the 31st. Opting for caution, I decided to proceed with the antibiotic. However, it's a medication I’ve never taken before, and while I’m not allergic to any medications, I have had previous adverse reactions to antibiotics. I had my prescription filled on Friday, yet I find myself uncertain if I should actually take the medication. This is the first time I’ve been prescribed antibiotics for a suspected infection without any confirmatory testing, and my condition seems to be improving. Although I still experience intermittent discomfort, it is not severe, and I have resumed a normal eating pattern. I even completed two at-home vaginal pH tests, which both indicated a normal pH level of 4.5, suggesting no infection. I am seeking guidance on whether it would be wise to wait for the ultrasound results before starting the antibiotic, or if I should proceed with it to preemptively tackle a potential infection. I understand clindamycin is a potent antibiotic, and I'm hesitant to disrupt my gut flora unnecessarily. However, I also want to avoid the risk of an untreated infection worsening. Thank you for your assistance!

Answers (1)

3/23/2025, 12:20:50 AM

OpenHealth AI

It's understandable to feel uncertain about starting clindamycin, especially given your medical history and current symptoms. Here's a breakdown of what to consider:

Main Points:

• There is a delicate balance between the potential benefit of starting antibiotics and the risks, especially for someone with ulcerative colitis and a history of adverse reactions to antibiotics.
• Given that your symptoms are improving, it may be reasonable to reassess the necessity of the antibiotic before starting it.

Explanation:

Clindamycin is an antibiotic that is effective against certain bacterial infections. Since your symptoms have shown improvement, alongside negative tests for UTIs and STIs, it's important to weigh the benefits of treating a possible infection against the potential impact on your gut health, particularly considering your ulcerative colitis.

You've noted that you have digestive issues with antibiotic use, and it’s wise to minimize any unnecessary disruption to your gut flora. Furthermore, the ultrasound on the 31st might provide more clarity about your condition without exposing you to the risks of antibiotic treatment right now.

Prioritized Next Steps:

1. Monitor Symptoms: Keep a close eye on your symptoms over the next few days. Since your discomfort is intermittent and you're feeling better, assess if there are any significant changes.

2. Consider Delaying Antibiotics: If you continue to improve and do not develop any new or worsening symptoms, you might decide to wait for the ultrasound results before starting clindamycin.

3. Communicate with Your Gynecologist: Reach out to your gynecologist's office. Share your concerns about starting antibiotics now and see if they recommend starting them in light of improving symptoms and negative test results.

4. Self-Care Measures: Focus on gentle self-care, ensuring you stay hydrated and maintain a balanced diet that works for you. This is especially important considering your history with ulcerative colitis.

5. Document Your Experience: Keep a log of your symptoms, dietary habits, and any changes you notice. This information can be helpful in discussions with your healthcare providers.

If any severe symptoms occur, such as intense pain, fever, or other worrisome signs, it would be wise to seek prompt medical attention. Please let me know if you have other questions or concerns!