Antibiotic Timing: Risks of Overlap and Dosage Concerns

Q: Antibiotic Timing: Risks of Overlap and Dosage Concerns

Hello： 1. <br>The usage of Dicloxacillin is four times a day. <br>Although the medication bag indicates to take it every 6 hours, it can also be divided into three doses after meals and one before bedtime, as long as there is an interval of at least 3-4 hours, which is acceptable

Antibiotic dosing intervals

I was hospitalized for a urinary tract infection on February 22 and discharged on March 1.
Upon discharge, I was prescribed Cipro (ciprofloxacin) to take two tablets every 12 hours.
On March 4, I went to the emergency room for cellulitis and received Decadron (dexamethasone) 250 mg, taking two tablets every 6 hours.
Currently, I am taking two types of antibiotics.
Just now at 11:42 PM, I was supposed to take Cipro, but I accidentally took Decadron instead.
I had already taken Decadron at 7:19 PM, which means there was only a 4-hour and 23-minute interval between the two doses, while the medication instructions indicate it should be taken every 6 hours.
I originally planned to take Decadron at 1:19 AM, so I took it 1 hour and 37 minutes earlier than scheduled.

1.
Will this short interval between doses lead to an overdose?
2.
What effects might occur due to the short interval between doses? Could it exacerbate side effects?
3.
I read online that the maximum single dose of Decadron is 250 mg.
The medication instructions state to take two tablets at a time; could this be too much? My weight is 85 kg; does that factor into this?

six four, 20~29 year old female. Ask Date: 2023/03/08

Dr. Lin Zhebin reply Family Medicine

Hello: 1.
The usage of Dicloxacillin is four times a day.
Although the medication bag indicates to take it every 6 hours, it can also be divided into three doses after meals and one before bedtime, as long as there is an interval of at least 3-4 hours, which is acceptable.
Based on the interval you described, there should not be a problem with overdose.
2.
Taking antibiotics with too short an interval may lead to overdose and associated side effects.
For Dicloxacillin, common side effects include loss of appetite, nausea, and diarrhea, among others.
3.
Generally, the recommended dosage of Dicloxacillin is between 125 mg to 250 mg per dose.
However, it is possible that a higher dosage was prescribed due to your higher body weight or the severity of your urinary tract infection.

Reply Date: 2023/03/08

More Info

When it comes to the use of antibiotics, particularly in your case where you are taking two different antibiotics (Ciprofloxacin and Dexamethasone), there are several important considerations regarding timing, dosage, and potential risks of adverse effects.

1. Risk of Overdose Due to Short Intervals: You mentioned that you accidentally took Dexamethasone only 4 hours and 23 minutes after your last dose, instead of the recommended 6-hour interval. This could potentially lead to an overdose, especially if the medication has a cumulative effect in your system. Taking antibiotics too closely together can increase the concentration of the drug in your bloodstream, which may heighten the risk of side effects. For Dexamethasone, common side effects include gastrointestinal disturbances, increased blood sugar levels, and potential effects on mood and sleep. If you experience any unusual symptoms, such as severe gastrointestinal discomfort, dizziness, or any signs of an allergic reaction (like rash or difficulty breathing), you should seek medical attention immediately.

2. Effects of Short Dosing Intervals: Taking antibiotics too frequently can lead to increased side effects. For instance, both Ciprofloxacin and Dexamethasone can cause gastrointestinal issues, and taking them too close together may exacerbate these effects. Additionally, both medications can affect your liver and kidneys, so it’s crucial to monitor for any signs of liver dysfunction (like jaundice) or kidney issues (such as changes in urination). If you have any pre-existing conditions affecting these organs, the risk may be higher.

3. Dosage Considerations Based on Weight: The maximum dosage for Dexamethasone is indeed often cited as 250 mg per dose, but this can vary based on the condition being treated and individual patient factors, including weight. At 85 kg (approximately 187 lbs), your body may handle the medication differently than someone who weighs less. The prescribing physician typically considers weight when determining the appropriate dosage, but it’s essential to follow their guidance closely. If you feel that the prescribed dosage seems excessive or if you have concerns about how your body is responding, it’s advisable to consult your healthcare provider.

In summary, while the accidental early dose of Dexamethasone may not necessarily lead to severe complications, it is essential to be vigilant about any side effects and to communicate with your healthcare provider about your medication regimen. They can provide personalized advice based on your health status and any other medications you may be taking. Always ensure that you are following the prescribed dosing schedule and do not hesitate to reach out for clarification if you are unsure about your medications.

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