Exposé: oxford mushroom is not a doctor but a doctor wannabe
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Originally posted by eggprata:I had posted an earlier post "Poor Service at SGH'.
http://sgforums.com/?action=thread_display&thread_id=254178
Well,thanks to them giving me instructions to take medicine properly,i've now got an infection at the wound area that has disabled its healing.The wound is still raw,no skin has come over it,bleeds a little.Stitching did not help at all.I was prescribed the medicine Co-Amoxiclav.And i was told to take it 'With Or After Food'.
Then yesterday they took out my stitches after 2 weeks.First week i was prescribed Co-Amoxiclav when i had went to A&E on the 11th of may,medication was for a week.They had to told me take if like mentioned 'with or after food'.So i went back for my first appointment on the 18th and doc said wound for some reason had not healed and gave me another week of mc and appointment.That time the doc gave me a new set of antibiotics.
So yesterday i went back which was on the 25th and had my stitches out,doc could still ask me 'why haven't heal ah?'.I could just stare at him.Then he gave me Co-Amoxiclav again.And instructions were take it with or after food.He said i had to do daily dressing myself.But i went to my family doc today whom my family has been going to for nearly 25 years now.Then i showed him the medicine and when he saw the label that said with or after food he told me 'You wanted to know why the wound never heal right? This medicine supposed to take BEFORE food,at least 1 hour before,not after,you take after it would hardly have any effect at all.No wonder the stitches did not help you'.I was really shocked.
I came home and went to the net and googled Co-Amoxiclav and came across the website http://www.patient.co.uk/showdoc/30003152/.Imagine my pain now,wound still raw,so much pain i am in.All thanks to SGH.I wonder how it is for other patients with even more serious infections.
Below is the pic of my medicine lable.It is abit blurred but can be seen.
http://i193.photobucket.com/albums/z173/anfieldroad_2007/as.jpg -
Originally posted by oxford mushroom:
The TS received an antibiotic that combines two drugs, amoxicillin (a type of penicillin) and clavulanic acid, a beta-lactamase inhibitor. The latter inhibits the breakdown of amoxicillin by some bacteria that are resistant through the production of lactamase, an enzyme that breaks down the antibiotic.
This combination is effective against a wide range of bacteria and has been used for more than a decade.
As for the pharmacokinetics, amoxicillin has greater oral bioavailability compared to PenV and ampicillin. This is what the FDA says:
"Approximately 74-92% of a single dose of amoxicillin is absorbed while approximately 60-70% of an oral penicillin V dose and 30-55% of an oral ampicillin dose are absorbed. Peak serum amoxicillin concentrations (Cmax) are reached 1-2 hours after an oral dose of the capsules, film-coated tablets, chewable tablets, or oral suspension [b]in fasting and non-fasting adults. Non-linearity in absorption of amoxicillin has been reported when increasing doses of 250mg, 500mg, and 1000mg of amoxicillin were administered to fasting adults. A significant reduction in the percentage of the dose absorbed was observed for the 1000mg dose (5)."
(http://www.fda.gov/cder/drugprepare/amox-anthrax.htm)
The clavulanic acid component is shown not to interfere with the absorption of amoxicillin and vice versa. However, oral absorption of clavulanic acid can be highly variable (http://cat.inist.fr/?aModele=afficheN&cpsidt=14518475).
The bio-availability of amoxicillin/clavulanic acid combination has been shown to be unaffected by food. Here's an abstract of a study done to address this very question:
"Augmentin’, the novel antibiotic formulation containing the ß-lactamase inhibitor, clavulanic acid, and the -lactam antibiotic, amoxycillin, has been the subject of two studies reported here on bioavailability and tolerance.
Eighteen subjects took part in a two-part crossover study to compare the bioavailability when taken fasting and with food. The bioavailability was shown to be unimpaired when taken with food.
Forty-five healthy subjects took part in a series of crossover studies to compare the tolerance of ‘Augmentin’ taken fasting and with food. ‘Augmentin’ was also compared with cephalexin under the same conditions. The gastro-intestinal side effects reported in these volunteer studies, which are rare in clinical practice, were reduced when ‘Augmentin’ was taken with food. "
(Staniforth DH, Lillystone RJ, Jackson D. Effect of food on the bioavailability and tolerance of clavulanic acid/amoxycillin combination. Journal of Antimicrobial Chemotherapy (1982) 10, 131-139)
In other words, this antibiotic combination can be taken either before or after meals. It does not matter to the bioavailability. However, because some people get tummy upset as a side effect of this antibiotic, the recommendation is to take it with food to reduce that side effect.
There are many reasons why the antibiotic did not work as well as it did. First, the bacteria may not be sensitive to the antibiotic. Perhaps the wound was infected with a bacteria that is not sensitive to this antibiotic or surgical debridement is needed. The medication the TS received sounds like a generic rather than Augmentin (the original 'branded' drug). Depending on where it was manufactured, the formulation and bioavailability may differ.
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Your pt is ?
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Originally posted by oxford mushroom:Haha..what response can there be to mindless ranting? The TS raised a question and I have answered it. On the other hand, you resort to wild allegations without a shred of understanding of the issue. Tsk tsk...
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Originally posted by maurizio13:
[b]You know why you couldn't answer my question as to "PQRSTU"? It's because you can't find any websites to give you anything conclusive, either that or you think that it has nothing to do with the medical profession.
Answering questions that could be found when you do a yahoo or google search is nothing to be proud of. I noticed that you were missing in action for a couple of days after the questions was asked. Were you busy researching the websites? It's not difficult for a person with a knowledge of biology to understand what was explained in those websites.
Claiming credit for answering a question, that is not someone who has professionalism in the medical profession does. Imagine a doctor coming in here, claiming credit because he managed to answer a question about antibiotics and telling a layman that he (as a doctor) can answer it but you can't. Why would a doctor go around telling people that he can answer those questions and you a layman can't? Just goes to prove that you aren't a doctor. Only a non doctor would need to prove to others that he is one.
I will tell you what is "PQRSTU" it's the different phases of a heartbeat measured on an electrocardiogram. It's in the syllabus of first year medical students, if you look up your first year medical physiology book, you will find it under "origin of the heartbeat and electrical activity of the heart" in Ganong.[/b] -
Originally posted by maurizio13:Frankly, "jljl" would be more of a doctor than you. Compare his/her reply to yours, you just cut and paste loads of crap to sound intelligent, that's what non-intelligent people need to prove. By putting so much medical jargon into your replies, goes to show how stupid you are. When you go see a doctor, is the doctor going to tell you about bioavailability, cephalexin, clavulanic acid and beta-lactamase.
Compare with jljl's reply:
honestly, taking augmentin or any other antiobiotics before or after food is not really a big issue. with food, augmentin or (co-amoxiclav) is easier on the stomach with less side effects...
more likely reasons that wound is not healing?
1. antibiotic not working because of bacterial resistance; ie need to change to another type of antibiotics
2. insufficient dose.. (taken twice a day, augmentin is actually very low dose.. sometimes u need up to three to 4 tabs /day ) to even make a difference
3. remnant unresolve wound problems e.g. unremoved stitches, deep seated bad infections that may need to be drained surgically
4. other poor skin healing factors e.g. genetically poor ability to heal, immune compromised (e.g. on long term steroids, diabetes, AIDs etc)
fyi
OM, you are a sad delusional individual, who has high ambition of being a doctor but failed. -
just ignore him as he's just a troll who is so lonely in london dat he going around in speaker corner to piss majority off.
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Sometimes, I wonder what we study history for. If humans can't learn from past mistakes made, please take off this subject from the book shelves.
Don't need to waste time, money and effort to study a subject that you will never learn. -
maurizio is so desperate that he resorts to personal attacks whenever he cannot win arguments...
I'll let the thread remain as a testimony to his antics 
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can summarize in less than 10 words?
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can summarize in less than 9 words?
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can summarize in less than 8 words?
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TS, imho most run-the-mill doctors and specialists that i've met in singapore are muddleheads anyway. For serious illness MOST of the time they prescribe an inefficient treatment/medication. Even with the expert s/w system to help them diagnose they still screw up. The main reason being that they see hundreds of patients and most of them don't really care much about their patients. In a 10 min consultation time slot the doctor is just going to type your symptoms into the computer and get the recommended medication/treatment answer.
Nowadays the correct medical information is available freely on the internet, I treat my own illnesses and buy my own medicine online via a reputable pharmacist. Cheaper and I don't have to pay the hefty consultation fee for some shoddy consultation work. Pay $75 for some idiot to type stuff into the computer, and to add insult to injury, get it WRONG? What a joke. -
As my secondary school teacher used to say, "A little knowledge is a dangerous thing." Each man to his own.Originally posted by Skibi:TS, imho most run-the-mill doctors and specialists that i've met in singapore are muddleheads anyway. For serious illness MOST of the time they prescribe an inefficient treatment/medication. Even with the expert s/w system to help them diagnose they still screw up. The main reason being that they see hundreds of patients and most of them don't really care much about their patients. In a 10 min consultation time slot the doctor is just going to type your symptoms into the computer and get the recommended medication/treatment answer.
Nowadays the correct medical information is available freely on the internet, I treat my own illnesses and buy my own medicine online via a reputable pharmacist. Cheaper and I don't have to pay the hefty consultation fee for some shoddy consultation work. Pay $75 for some idiot to type stuff into the computer, and to add insult to injury, get it WRONG? What a joke. -
Thank you so much, SingaporeTyrannosaur.
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Haha...shows how desperate this lot are. Having been humiliated time and again in debates at Speakers Corner they now launch personal attacks in a totatlly unrelared forum. I can delete their posts but no, I would rather let their antics demonstrate why Singaporeans are not ready for western-style democracy. If the Opposition parties are composed of folks like these, it's no wonder they have lost and will keep losing general elections.
