Cefdinir antibiotic for ear infection amplifying taper s/x.

In February, and again now, in July, I’ve had terrible ear infections. It starts with my ears clogging up, like I’m on an airplane, then it feels like there’s liquid in them, sloshing around, making it difficult to hear. The next stage is them swelling up, and eventually shut. The lymph nodes under my jaw are swollen and painful, and everything gets worse when I lie down. It’s extremely frustrating.

When it happened this time in the beginning of July, I was convinced it was due to my lymph nodes reacting to a COVID infection. I got tested, and fortunately, I came back negative today.

My doctor prescribed Cefdinir to me in February and again this month, and it slowly knocks out the ear infection, but the medication is killing me. It ramps up my worst side effects to the worst level they’ve been throughout my nine-month taper. I have terrible insomnia, only sleeping 1-2 hours every 24 hours; shortness of breath, which is worse when I lie down; anxiety; depression; cognitive fog and confusion. Also, my benzo belly somehow swells up even larger when I take the Cefdinir.

I’m supposed to take 2 per day for 14 days, but I’ve only managed to take 15  over 11 days, so far. It basically comes down to a choice between being able to hear, and not have constant liquid sounds in my ears, versus being able to sleep, breathe and function.

I’ve searched the site for other posts about Cefdinir, but all of the ones I’ve found have been positive.

Has anyone else had problems with Cefdinir amplifying taper symptoms?

I found this information about Cefdinir, a beta-lactam (along with Amoxicillin). Cefdinir is a GABA-A antagonist, which can cause seizures, hallucinations, delirium and psychosis in people who are not tapering, or in withdrawal from Benzo. Chronic use of Benzos is a risk factor that makes the probability worse.

https://www.psychiatrictimes.com/view/psychiatric-adverse-effects-antibiotics

This is an older medical study done by NIH which discusses the CNS dangers of multiple antibiotics, including Cefdinir and Amoxicillin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175508/

In my case, I ended up taking 21 capsules of Cefdinir, which knocked-out my ear infection. Ten days after stopping, I finally felt good enough to feel I was out of acute withdrawal, but it ended up taking 21 days for me to feel “cured” from the antibiotics. On day 22 (yesterday) I began having symptoms of another ear infection.

I don’t know what I’ll end up doing, but I know I’m not going to take any Cefdinir, and I’m going to wait a long time before taking any antibiotics. I hope the ENT I plan on seeing listens to my worries about taking them.

You've done an incredible amount of research, thank you for posting it here because it will help the next person who faces what you're dealing with, I'm so sorry there isn't more information to help you.

There are so many antibiotics out there, your Dr needs to listen to your concerns, you shouldn't have to suffer like this. 

You've done an incredible amount of research, thank you for posting it here because it will help the next person who faces what you're dealing with, I'm so sorry there isn't more information to help you.

 

There are so many antibiotics out there, your Dr needs to listen to your concerns, you shouldn't have to suffer like this.

Thank you, Pamster!

Hi, Libertas!

The two papers I cited indicated that cephalosporins cause certain problems, without specifically citing Cefdinir, and also state that beta-lactams, the group to which cephalosporins belong, may act as GABA-a antagonists, with "chronic benzodiazepine" being one of the risk factors (see Table: Various neuropsychiatric adverse effects caused by antibiotics, in psychiatrictimes article):

https://www.psychiatrictimes.com/view/psychiatric-adverse-effects-antibiotics

Also, re: beta-lactams:

Beta-lactams include penicillins, cephalosporins, and carbapenems. Generally, they are considered broad spectrum antibiotic agents that may act as GABA-A antagonists in a dose dependent fashion to produce neurotoxicity. The beta-lactam ring is structurally similar to the GABA antagonist bicuculline. CNS effects include seizures, encephalopathy, tremors, hyperactivity, and excitability.

Also, from the second article, re: third-generation cephalosporins:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175508/

Cephalosporins

Neurotoxicity has been reported with first generation cephalosporins such as cefazolin, second generation such as cefuroxime, third generation such as ceftazidime and fourth generation such as cefepime and can range from encephalopathy to non-convulsive status epilepticus [13] (Table 1). This is particularly true in the setting of renal impairment though cases also exist in those with normal creatinine clearance. Previous CNS disease has also been suggested as decreasing the threshold of nervous system toxicity with use of third and fourth generation cephalosporins [14]. In addition to pre-existing CNS conditions, reduced creatinine clearance, impaired renal function and excess dosage of medication have been described as independent risk factors for neurotoxic effects [15]. The typical time period for encephalopathy induced by cephalosporin use is a latency of 1 to 10 days following start of medication, and resolution in 2 to 7 days following discontinuation [16].

Clinical presentations of cephalosporin-associated neurotoxicity include tardive seizures, encephalopathy, myoclonus, truncal-asterixis, seizures, non-convulsive status epilepticus (NCSE) and coma [13]. One case series described eight patients who developed neurotoxicity with use of cephalosporins in the setting of renal failure. Their myriad of neurological symptoms included lethargy, confusion, agitation, global aphasia, chorea-athetosis, seizures, myoclonus and coma, which were slowly progressive in evolution. EEGs of all patients demonstrated diffuse slowing with triphasic waves suggestive of toxic-metabolic encephalopathy (without any epileptiform features) [17]. Mortality was high in all cases...

As with other beta-lactams, the basic mechanism for this neurotoxicity includes decreased gamma-aminobutyric acid (GABA) release from nerve terminals, increased excitatory amino acid release, as well as cytokine release [33, 34]. Other postulated mechanisms for cephalosporin neurotoxicity also include induction of endotoxins and, possibly, glutaminergic mechanisms. Laboratory studies also show that cephalosporins with high affinity for GABA-A receptors and those with high penetrance through the blood-brain barrier are more neurotoxic [34].

I understand that everyone has a different tapering and withdrawal experience, and I was not trying to say that everyone will react to Cefdinir the way that I have. But I will tell you that throughout a somewhat-aggressive taper from 2.5 mg K down to 0.023 mg K, during which I also c/t off of Ambien, cigarettes and caffeine, I've seen some dark times, but absolutely nothing was as bad as what I went through the two times I used Cefdinir, the second time being worse than the first time. 

If we can say that benzo-tapering, or -withdrawing folks should possibly stay away from the class of Fluoroquinolones, I don't see why we would not inquire into the use of the class of beta-lactams, or cephalosporins.

Thank you for responding, Loveisalluneed.

 

I am all for inquiry but, as laypeople, might I suggest we need to be careful about making claims regarding prescription medications?

 

With all due respect, in my opinion, the two papers you cited do not constitute credible and sufficient evidence that the entire class of cephalosporin antibiotics warrant a warning on par with the one for fluoroquinolone antibiotics. This is why I asked if you could provide additional evidence.  If you can, please do so!  I would welcome the opportunity to learn more and am confident other members of the community would as well. 

 

In closing, let me hasten to add that I acknowledge and empathize with your personal experience with taking cefdinir.

 

 

Edit: corrected for redaction

Libertas, you sound like you're a trial lawyer. I am, too. Let's get into this.

I appreciate your diplomatic tone, but I am unsure what it is about what I have written that has you so concerned.

I've not told anyone to refrain from prescribing Cefdinir, or to refrain from using same. I also haven't averred that "the entire class of cephalosporin antibiotics warrant a warning on par with the one for fluoroquinone antibiotics." 

I have simply reported my very real reaction to Cefdinir while tapering from Klonopin, and cited authority that indicates that beta-lactams may act as GABA-a antagonists, with "chronic benzodiazepine" being one of the risk factors therefor, and that neurotoxicity has been been reported with third-generation cephalosporins, with CNS disease having been suggested as decreasing the threshold of nervous system toxicity. 

Further, as to third-generation cephalosporins, like Cefdinir,

"Other rare reactions to some third-generation cephalosporins include seizures and disulfiram-like reactions. Concerning neurotoxicity, apart from the well-known epileptogenic activity, cephalosporin-induced neurotoxicity may occur in a variety of clinical presentations, including myoclonus, asterixis, and encephalopathy. The pathogenetic mechanism is not well understood, but it is probably related to the competitive antagonism of gamma-aminobutyric acid (GABA)."

With all due respect, you have not refuted anything that I have written here.     

I don't know if this is some weird sort of flex on your part, or if you're working for big pharma, or what.

'

I'm not trying to hurt you. I'm not "coming at you." I'm simply recording my experience in tapering off of Klonopin, having taken Cefdinir during same, and hoping to help others who may some day read this if they have similar reactions to mine.

Thank you for responding, Loveisalluneed.

 

I am all for inquiry but, as laypeople, might I suggest we need to be careful about making claims regarding prescription medications?

 

With all due respect, in my opinion, the two papers you cited do not constitute credible and sufficient evidence that the entire class of cephalosporin antibiotics warrant a warning on par with the one for fluoroquinolone antibiotics. This is why I asked if you could provide additional evidence.  If you can, please do so!  I would welcome the opportunity to learn more and am confident other members of the community would as well. 

 

In closing, let me hasten to add that I acknowledge and empathize with your personal experience with taking cefdinir.

 

 

Edit: corrected for redaction

 

Libertas, you sound like you're a trial lawyer. I am, too. Let's get into this.

 

I appreciate your diplomatic tone, but I am unsure what it is about what I have written that has you so concerned.

 

I've not told anyone to refrain from prescribing Cefdinir, or to refrain from using same. I also haven't averred that "the entire class of cephalosporin antibiotics warrant a warning on par with the one for fluoroquinone antibiotics." 

 

I have simply reported my very real reaction to Cefdinir while tapering from Klonopin, and cited authority that indicates that beta-lactams may act as GABA-a antagonists, with "chronic benzodiazepine" being one of the risk factors therefor, and that neurotoxicity has been been reported with third-generation cephalosporins, with CNS disease having been suggested as decreasing the threshold of nervous system toxicity. 

 

Further, as to third-generation cephalosporins, like Cefdinir,

 

"Other rare reactions to some third-generation cephalosporins include seizures and disulfiram-like reactions. Concerning neurotoxicity, apart from the well-known epileptogenic activity, cephalosporin-induced neurotoxicity may occur in a variety of clinical presentations, including myoclonus, asterixis, and encephalopathy. The pathogenetic mechanism is not well understood, but it is probably related to the competitive antagonism of gamma-aminobutyric acid (GABA)."

 

With all due respect, you have not refuted anything that I have written here.     

I don't know if this is some weird sort of flex on your part, or if you're working for big pharma, or what.

'

I'm not trying to hurt you. I'm not "coming at you." I'm simply recording my experience in tapering off of Klonopin, having taken Cefdinir during same, and hoping to help others who may some day read this if they have similar reactions to mine.

This is not an appropriate comment directed towards someone who is very careful about giving accurate information to our members.

Every drug has side effects, even OTC drugs. Do you have any data on the percentage of time the side effects you describe occur?  I notice that the statement you quoted references the word 'rare'.

I can assure you that Libertas does NOT work for big pharma.

pianogirl

I have shared my very real account with you. I took Cefdinir twice during my slow-taper, and both times, it was terrible. The second time I had to take it, was the worst month-plus of my life.

I am now 14 days off Klonopin, and I have not felt better in the last 6 years. My lungs have magically opened up. Three days post jump, I felt the gears of my brain mesh, and my brain started cranking again. I feel so much better.

Libertas, and pianogirl, you two gals make me feel like I'm being accosted by my HOA. I can't see you, but I know exactly what your haircuts look like.

Libertas, and pianogirl, you two gals make me feel like I'm being accosted by my HOA. I can't see you, but I know exactly what your haircuts look like.

Loveisalluneed,

I'm truly happy you're feeling better but making a disparaging comment in unacceptable, please show respect to your fellow buddies and volunteers who come here day after day doing their best to help others.

Pamster