Medication Effects: Kidney Health, Antibiotic Resistance, and More

Pharmacological Efficacy Questions

Hello, Dr.
Huang...
1.
From high school until now, approximately 30 years, I have often had trace amounts of protein in my urine (+/-) during health check-ups, with a creatinine level of 1.0.
Fortunately, it has remained stable without worsening.
Looking back, during high school, I frequently took herbal remedies for nasal allergies, such as Bu Zhong Yi Qi Decoction, and when I had excessive heat, I used Liu Wei Di Huang Wan.
For fevers, I took Niu Huang Wan.
After high school, I reduced my intake of traditional Chinese medicine.
I wonder if these medications could have affected my kidney function? 2.
I often catch colds that start with a viral infection, which usually progresses to a lower respiratory tract infection (bacterial, with yellow mucus and phlegm).
Doctors prescribe antibiotics, but often they start with a spore-type antibiotic, which still leads to a lower respiratory infection later on.
The doctor may suspect antibiotic resistance and then switch to Ciflogen.
Although it is effective, I have learned about resistance issues in recent years (previously, I would take it for 3 days and stop when symptoms improved, and the doctor never mentioned it; now I have to take it for at least 6 days).
I have taken it for nearly 12 days, and the side effects include fatigue and some dysfunction of the eustachian tube (slight hearing loss, a feeling of fullness when listening or speaking loudly).
Most symptoms have subsided, so I stopped taking it, but I still have a persistent post-nasal drip with thick mucus, coughing up some phlegm about once an hour, which still has a trace of yellow-green color.
Does this mean the bacteria were not completely eradicated? Additionally, is antibiotic resistance specific to the same type of antibiotic, or does it occur when switching between different antibiotics? As long as I continue taking them, will there be no resistance? If I have no yellow phlegm next time I get sick, can I start with the most basic antibiotic again? 3.
Due to my nasal issues, doctors often prescribe medications for nasal congestion and allergies, but now my condition involves a small amount of post-nasal drip, easy fatigue, dizziness, etc., resembling chronic sinusitis.
The nasal congestion and allergy medications prescribed by the doctor seem completely ineffective (at least for 3 months), as my symptoms have not improved.
Sometimes, they seem to lessen naturally, possibly related to the weather.
Recently, I explained this to my doctor, and they prescribed medication for Meniere's disease (which I found online; the doctor did not mention it at all).
However, my dizziness is only a feeling of heaviness, and I do not experience vertigo or incapacitating symptoms.
I recall that last year at another hospital, I was prescribed eUClidan, took one pill, felt drowsy all day, and my symptoms did not improve at all.
This time, I tried Suzin, diphenidol, and benamine (3 pills), but the result was the same as last year; I felt even sleepier for half the morning, and my symptoms did not improve.
I am hesitant to take these medications again.
In such cases, should I consider these medications ineffective? Aside from antibiotics, which I feel I must complete, is it acceptable to stop taking the others? 4.
How can I protect myself from being prescribed many unnecessary medications?

BEE, 0~9 year old female. Ask Date: 2015/04/18

Dr. Huang Shenggang reply Pharmacology

Hello, thank you for your questions.

1.
Regarding the use of traditional Chinese medicines such as Bu Zhong Yi Qi San, Liu Wei Di Huang Wan, and Niu Huang Wan, if they are prescribed by a physician, please take them as directed.

2.
Antibiotic resistance refers to the reduced effectiveness of a medication in treating a disease or alleviating a patient's symptoms.
It is essential to complete the full course of antibiotics; please do not stop taking them on your own!
3.
Please remember not to make your own decisions about discontinuing medication!
4.
If there are any unnecessary medications, please advise your physician not to prescribe them.
Thank you!

Reply Date: 2015/04/18

More Info

Understanding the effects of medications on kidney health, antibiotic resistance, and overall well-being is crucial, especially for individuals with a history of kidney issues or those taking multiple medications. Here’s a comprehensive overview addressing your concerns.

1. Impact of Traditional Chinese Medicine on Kidney Function
You mentioned using traditional Chinese medicines such as Bu Zhong Yi Qi San, Liu Wei Di Huang Wan, and Niu Huang Wan over the years. Generally, these herbal remedies are considered safe when used appropriately and under the guidance of a qualified practitioner. However, some herbs can have nephrotoxic effects, particularly if taken in excessive amounts or if there are pre-existing kidney conditions. Given your history of trace protein in urine and stable creatinine levels, it’s advisable to consult a healthcare professional familiar with both Western and traditional medicine to evaluate the long-term effects of these herbs on your kidney function.

2. Antibiotic Use and Resistance
Your experience with recurrent respiratory infections and the use of antibiotics raises important points about antibiotic stewardship. Antibiotics like penicillins and cephalosporins can be effective against bacterial infections, but their overuse can lead to antibiotic resistance. This means that bacteria evolve and become less susceptible to these medications, making infections harder to treat.

If you have been prescribed antibiotics multiple times for similar symptoms, it’s essential to ensure that the infection is indeed bacterial and not viral, as antibiotics are ineffective against viruses. The presence of yellow-green phlegm may indicate a bacterial infection, but it’s not definitive. A culture test can help determine the specific bacteria involved and guide appropriate treatment.

Regarding antibiotic resistance, it typically develops when antibiotics are used improperly, such as not completing a prescribed course or using them for viral infections. If you have fully recovered from an infection, it may be safe to return to basic antibiotics for future infections, but this should always be discussed with your healthcare provider.

3. Chronic Sinus Issues and Medication Efficacy
Your ongoing symptoms of nasal congestion and post-nasal drip suggest a possible chronic sinus condition. The medications prescribed for allergies and nasal congestion may not always provide relief, especially if the underlying issue is not addressed. If you feel that the medications are ineffective, it’s crucial to communicate this to your doctor. They may consider alternative treatments, such as nasal corticosteroids or saline rinses, which can help alleviate symptoms without the side effects associated with prolonged use of decongestants.

4. Managing Unnecessary Medications
It’s understandable to be concerned about being prescribed multiple medications, especially if you feel they are unnecessary. Here are some strategies to manage your medications effectively:
- Keep a Medication List: Document all medications you are taking, including dosages and reasons for use. This can help you and your healthcare provider assess the necessity of each medication.

- Regular Check-ups: Schedule regular appointments with your healthcare provider to review your medications. Discuss any side effects or concerns you have about their efficacy.

- Seek a Second Opinion: If you feel overwhelmed by the number of medications or unsure about their necessity, consider seeking a second opinion from another healthcare professional.

- Educate Yourself: Understanding your health conditions and the medications prescribed can empower you to make informed decisions about your treatment.

Conclusion
In summary, while traditional Chinese medicines can be beneficial, their long-term effects on kidney health should be monitored. Antibiotic use must be judicious to prevent resistance, and ongoing symptoms should be addressed with your healthcare provider to ensure appropriate treatment. Lastly, managing your medications proactively can help you maintain your health and well-being. Always consult with your healthcare provider before making any changes to your medication regimen.

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