Q:I suffer from acne and my doctor has given me tetracycline to take
for a year or more. He has told me not to take it with milk because it
interferes with the medicine’s action. Is there anything else I should
be careful not to take it with?
A: Tetracycline, also known as achromycin or sumycin, is an antibiotic
often used in the treatment of severe acne and other infections,
usually lung conditions such as bronchitis. It is not a powerful drug
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since it slows down the bacteria’s rate of reproduction rather than
killing it. This allows the body’s natural defence mechanisms to work.
Because it is less likely to wipe out the good bacteria in the
intestines and vagina, secondary yeast infections
are not as common, and therefore tetracycline is a good choice for
long-term use.
However, there are some drawbacks as you mentioned. Tetracycline does
interact with milk, cheese and other substances containing calcium,
making it less effective. It also reacts with other minerals such as
magnesium and aluminum, and to some extent iron and zinc.
These are commonly found in antacids and vitamin tablets. It can also
interfere with the activity of potassium, and the vitamins B2, B6, B12,
C, K and folic acid. This is not a problem for a person who only needs
to take it for a couple of weeks, but for long-term use, you might want
to supplement B and C vitamins.
Regular tetracycline is usually taken four times a day, which makes it
inconvenient to avoid the dairy products. An alternative would be
doxycycline or minocycline (Minocin).
These need only be taken twice a day, even for more severe infections,
and are much less likely to be interfered with by the above mentioned
minerals, dairy products and antacids.
There is always a catch. These drugs are much more expensive and have
other side effects, such as stomach irritation and dizziness in some
patients.
None of these medications should be given to children or pregnant
women. They can cause a yellow discolouration of the teeth in the
developing child.
Q: How often do doctors make mistakes?
A:I know from reading reports from the College of Physicians and
Surgeons that there are one or two cases a year in Canada where doctors
are investigated for claims of medical malpractice. Half of those cases
find the doctor guilty.
Malpractice means that most doctors dealing with a similar condition
would have done things differently. It does not necessarily mean the
doctor has to always be right. He is allowed to make some mistakes or
human errors, as long as other doctors might have easily made the same
mistake. For example, some
diagnoses are difficult to make.
Actually, more mistakes occur in the dispensing of medications by
pharmacists or nurses. It is important to always check that you have
the correct prescription. If it doesn’t look right, don’t hesitate to
question it.
Unfortunately, in nursing homes, the patients are often too debilitated
to notice what they are taking. On the positive side, a lot of them are
taking the same medications so these mistakes are rarely fatal.
If you want to check statistics further, I suggest you look into the
College of Physicians and Surgeons of Alberta at www.cpsa.ab.ca. The
college looks after your rights as a patient or patient’s relative.
In the year 2000, it received 365 complaints regarding quality of
patient care. Of all the complaints, and this included problems with
files and office management, only five went as far as a formal hearing.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor regarding
medical questions and treatments.
