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Rifampicin and Clindamycin

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Guest

I've been reading the board and haven't seen any mention of this combination of antibiotics. I'm a dermatologist and I have found this very effective in many patients with HS and similar problems. A 3 month course tends to bring about a lasting remission and then can be repeated as necessary. One or two patients have not been able to take the full course due to stomach upsets but I would say 95% of people can tolerate it very well. I've probably used it 50-60 times over 6-7 years.

I usually mention it when I give talks to GPs because I know a lot of people are not aware of it.

I am based in South Wales and if anyone would like to come and see me on the NHS feel free to ask your GP for a referral.

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0 likes, 42 replies

42 Replies

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  • tom85153
    tom85153 Guest

    Posted

    I hope you recommond diet and lifestyle changes in combination to antibiotics. Dermatologists don't usually even entertain the idea that diet can treat HS. I found Diet is the only thing that treats my HS, whilst years of antibiotics did nothing. 
  • Dottipants
    Dottipants Guest

    Posted

    Hi, Ive tried that combination and Ive had Roaccutane and surgery, am now looking at biological response modifiers however that isnt available on the NHS. Do you have any other suggestions?
  • dita70245
    dita70245 Guest

    Posted

    Thank you, thank you, thank you for caring about all of us who have lost sooooo much to this disease. The morning routine that everyone takes for granted; to the time lost with our children. To the dedicated spouses and good doctors that care.!!!! No one can understand what these nodules feel like, because it's about sooo much more than that. It saddens me to know that I need to do my own research and that I've had to live with this disease that is over 100 years old. In 100 years there has been very little research. We all have a voice and even though our disease is not cancer it is extremely debilitating. I've had to learn to look past the ignorance that I get from doctors about my food choices or about my cleanliness. FYI world!!!! The routine that we HS sufferers have makes us sterile, not just clean. I wish that there were more doctors like you that cared about the disease the way you do. Thank you again!!!!
  • md123456
    md123456 Guest

    Posted

    I know this was posted over a year ago but I was recently diagnosed with HS but i've had it for 8 years. My GP perscribed me to lymecyline 408mg but I have been hearing a lot about this combonation. Do you think this is more effective than lymecyline. Really desperate for this to get better. Thank you.
  • daisy96488
    daisy96488 Guest

    Posted

    I was on this combination and it put me in hospital for a week with a very high fever and high heart rate. This was very dangerous for me so please take care.
  • aussie76
    aussie76 Guest

    Posted

    I was given 450mg of Clindamycin 3 times a day for about 3 weeks while I was getting a Pilonidal Abscess removed...  my HS went into remission (which was pretty significantly bad).

    When I stopped the course my armpit flared mildly and I got another 4 days worth as a precaution because I was still healing the other wound.

    After those 4 days further Clindamycin .... I came off everything... and this time it didn't flare and I'm amazed 6 weeks later... still no HS flares or pain!

    I'm also taking probiotics.. and wondered if they are helping.

    I went to a well respected dermatologist (Australia) and he didn't seem aware at all of C+R option at all.  He tried bactrim (allergy!) and loads of roaccutane.  If it ever flares again I'll be down there to tell him about C+R!!!!

  • jessica45150
    jessica45150 Guest

    Posted

    Hi my mom and I both have h.s hers is much worse than mine...I have learned that it is an autoimmune disease... I just moved home back to Louisiana from Oklahoma and I have more flare ups here than I do in Oklahoma... I was just put on rafampin I've been on it for four days now I'm very tired and have lots of pain around my kidneys...is this normal
  • oz7
    oz7 Guest

    Posted

    Hello

    I just started on this combo treatment. I'm taking clindamycin 300 mg and rifampin 300 mg. However, my rifampin pill also has isoniazid 150 mg, is that normal? It's only been 2 days since I started this treatment, and will continue for three months. Just not sure about the isoniazid component. Should I continue?

  • EllesMom
    EllesMom Guest

    Posted

    Hello! I'm in the US and took this combo in late 2011 but only took it for 3 weeks when the inflammation and boils subsided and remission lasted about 2 years. My GP now doesn't want to put me back on it tho because of the incidence of C Diff. I found your post through a Google search for the combo and HS. I have just been given an RX for Clindamycin only from my dentist for a tooth problem and was looking for information to see if the Clindamycin alone would place me back in remission.

    • EllesMom
      EllesMom

      Posted

      My GP at the time had me stop the meds once he saw it clear up. He didn't have a specific time for me to take it, just gave me a months supply and I went in weekly for 3 weeks and saw dramatic improvement quickly!

    • oz7
      oz7 EllesMom

      Posted

      I was told by my dermatologist to take the combo for 3 months. My 3-month therapy ends on August 22nd (almost finishing). During the time of the therapy I haven't had a flare up. I cannot comment on the post treatment result since I'm still on the therapy. However, I shall update in the coming months how well it worked for me.

    • Scott1986
      Scott1986 EllesMom

      Posted

      Hi EllesMom. I have been on the rifampin and clindamycin combo twice now and with very good results. You have to have a minimum of 12months of taking nothing before starting it again because it can cause serious damage if you take it all the time. The courses were 3months long. Each time putting me into remission for about 12months. The first time I took it I had no side effects whatsoever (I know some people can't tolerate it at all). The second time I had a banging headache day and night which wouldn't go away. Realised it was the rifampin and stopped taking it but carried on taking Clindamycin. When I went back to my dermatologist, he said that it wasn't good taking clindamycin on its own without rifampin because you build up a tolerance to it and it won't work effectively again. That's for 3 months though, if taking a short course for tooth problem you should be okay. But like any medicine really, the more you take, the tolerance will build up over time. Clindamycin on its own may or may not put you into remission for X amount of time. Everyone is different and reacts differently to medicines. My advice is, it shouldn't be taken on its own for a long period and also shouldn't keep being taken. Eventually it may stop working like with everything else. Clindamycin and also rifampin long term can cause serious problems thats why it can only be a max of three month course for the combo then 12 months minimum wait before taking it again. I am currently enjoying remission after my course of rifampin and clindamycin and that ended in January. If you want any more info then just let me know. Take care. Scott.

    • EllesMom
      EllesMom Scott1986

      Posted

      Thank you Scott! Very good advice and I'm so glad to hear you are in remission and feeling well. Luckily the Clindamycin I'm on now is only for 10 days. It is a great drug for skin and dental procedures. I have an appointment with a new dermatologist that moved to town recently. In the past, we haven't had one and have had to travel over an hour any direction to see one. I'm looking forward to seeing this doc and hoping she can help and has some updated knowledge on the disease. I'm sure in your journey with this disease, you've met some professionals who don't know a thing about it. Luckily, being an RN, I have a new family practice doc that understands I know more than the normal person about medicine. I really liked too that he told me too that I know more about the disease than he does and he appreciates me coming in with info I have researched and not taken from small articles on the Internet, but actual research articles done.

    • EllesMom
      EllesMom oz7

      Posted

      That's great to hear you haven't had any flare ups and I'm hoping you stay in remission for quite a while now. Please let me know how things go. It is nice to have a break every once in awhile, isn't it? Even if it's for a year or so, a break is nice to be able to feel a little more in control and not be suffering all the time. Best of luck and please let me know how things are going.

  • mark1209
    mark1209 Guest

    Posted

    Good day all out here in South Africa. I've been suffering from this disease for just over 10 years and its the most horrible thing ever. The depression, the embarrasment, the excrutiating pain. I am so happy to have finally found this group. i thought I was going to be stuck with this forever, because tablets weren't working that GP's were giving me. Until I finally found a GP that could tell me I have HS, however he just gave me a normal antibiotic for 1month that just didn't help at all. I will now be going to my new GP with all this info I have picked up on this forum so I can start beating this condition and slowly start piecing my life back together again. I am so glad to have found you all. Keep fighting the fight and thanks for all your info. I feel like a new person again having found all this helpful info. Stay blessed my fellow HS brothers and sisters

    • EllesMom
      EllesMom mark1209

      Posted

      Please do realize that while there are several ways to fight the pain and bring down the inflammation and boils, you will still have some problems with it for the rest of your life. I have had it for 16-17 years and its comes and goes with small to large flare ups. Remission is possible for perhaps a year or two, but it can come back and with your depression, I want you to be armed with info. I hate to be a party pooper, but it helps my depression knowing I have good days and bad days and not every single is in severe pain. I had a remission of about a year and that was nice and even a week break is nice once in awhile. But I haven't taken some of the stronger medications and treatments like surgery and Humira and such.

    • mark1209
      mark1209 EllesMom

      Posted

      I agree that this is a life long problem, but the feedback I have read here so far, this would at least be a start to a much better quality of life. Thanks for being a part pooper LOL, but that is good that you state the facts and arm me with as much info as possible. Have you noticed if certain foods trigger or make the condition worse? I have read that I should stay away from spicy foods (curries, etc), sugar, dairy products and mutton/lamb
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