Clindamycin.. one day or five days a month??

[MelissaKathryn]

Hey Everyone!
Since I was last on here, I had a very successful visit with Dr. S and a lovely stay in Iowa the first week of July. My family and friends have noticed a big difference in me since my return and I had noticed that the pain and swelling associated with psoriatic arthritis have gone down tremendously in the past month. I barely herxed, but still flare a bit when I am under high stress at work or pull an all-nighter (my fault-I know, I know!). I have also been to an Integrative Medicine doctor in my area since I last saw Dr. S, to help keep me on IV Clindamycin once a month. He set me up with a home nursing company that takes my insurance that gave me a call the other day. The man on the phone said that this Integrative Medicine doctor prescribed me 300mg Clindamycin IV for FIVE days. Back in July, Dr. S had told me that I would continue to receive the IV Clindamycin just one day a month and 800 mg of it.
Does anyone on this site have any tips as to what is the most effective dose? Is it worth the hassle of doing this 5 days a month at 300mg as opposed to 1 day a month at 800mg? I’ve noticed everyone on here is on all kinds of different APs and many seem to either involve no IVs, or almost half oral and half IV, so I know there could be quite a range in responses. The last thing I want to do is add “Drug Induced Lupus” to my current list of Systemic Scleroderma with CREST Syndrome and Psoriatic Arthritis and Psoriasis. However, this Integrative Medicine Doctor also brought up the use of certain anti-opiates and anti-malarials to treat psoriatic arthritis in addition to the AP, so he may be more on the “cutting edge” of things.. I just have no idea! There’s too much to learn out there!
Thank you so much for your time! I look forward to when I will be able to provide more answers than questions!
Sincerely,
Melissa

[torontogirl]

I have systemic scleroderma too. I’m not familiar with Dr. S’s protocol with Clindamycin, but I know he’s one of the top doctors for treating rheumatic disease with antibiotics so I would probably defer to his opinion. He must have a great deal more experience than your local doctors. Perhaps you could email/call Dr. S to discuss this or see if he’d be willing to tell your integrative medicine doctor what protocol to follow.

I have not start Clindamycin yet, but the doctor who prescribed Minocycline is willing to prescribe it as well. He has an IV clinic attached to his office where it can be administered. He suggested 900 mg once a week for 10 weeks, I think. I have not followed through with it yet as I wanted to do some research and ask the people here who are more familiar with Clindamycin. My doctor supports the IDEA of AP, but is not all that familiar with the particulars of how to use it. He did say that he sees faster results in some patients with RA if they use IV abx as opposed to oral. He is willing to let me stay on the Minocin and add Clindamycin when I decide to. But he really has no clue about the timing and dosage.

[notabene]

I had the five-day regimen (300 mg x3 daily) of IV Clindamycin from Dr. S. in May. Since I live some distance from Iowa, he gave me a prescription for a once monthly dose of oral Clindamycin (300 mg x 3), which has been working out very well.

I agree that you should contact Dr. S. for an opinion, asking that he contact your local doctors.

[MelissaKathryn]

Thank you very much for your input! and good luck on the IV when you get it! It really helps a lot!

I really really appreciate your input,
Melissa

[kwlile]

You’re right, it does seem that there is a great variety in treatments out there. I have SD and go to Dr. F in Riverside, CA. He’s prescribed a week (5 days) of IVs (900mg/day) each month for me.
I too, would follow Dr. S’s advice – he and my Dr. have the most experience with this, from what I’ve read.

Good luck!

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