Dr.D's Antibiotic Brief

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    Dr.D's Antibiotic Brief


    As promised, here's a basic antibiotic sticky. For specific questions not addressed here, feel free to PM.

    Here's some basic info on how they work. If you do not understand how to apply this info, and feel you may have an infection, it's best to consult your doctor for clarification.

    Antibiotics are chemical compounds either from living or synthetic sources that, in low concentrations, are capable of inhibiting the life processes of microorganisms. ABs are either "-cidal" or "-static" meaning that they either directly kill or inhibit further reproductive cycles of the microbe.

    Short breakdown of the common AB classes:

    PENICILLINS:
    Crystalline (powder) and salt forms (pills) are stable at room temperature for years. Although they do not require cold storage, they must be kept dry. The water-insoluble salts are often stable in solution for up to 6 years at standard refrigeration temp. 1.0mg of Pen G Procaine salt is equal to 1009 units. Some are allergic to pens and should determine sensitivity before use. Eating is usually not a problem with oral pen but buffers and anti-acids are to be avoided. This class is active against gram (-) and some gram (+) organisms.

    Common products, doses and duration of therapy:
    Pen G Procaine: 600,000u IM once daily or EOD for 1-10days
    Pen G Benzathine: 1,200,000u IM 1-2x/wk for 1-2 weeks (long acting)
    Pen V: 125-250mg Oral 4x/day for about 2 wks
    Ampicillin: 250-500mg Oral 4x/day for 10 days
    Amoxicillin: 500mg Oral 3x/day for 10 days
    Augmentin: 875mg Oral 2x/day for 10 days (this is a strong form of Amoxil)

    CEPHALOSPORINS:
    These compounds are bacteriocidal in a similar way as to pens. They interfere with bacteria cell wall cross-linking. Although they are closely related to pens, people are less likely to demonstrate allergic reactions. This class has gram (-) and gram (+) activity. These are generally very good for soft tissue infection like an athlete my encounter. They start to work very quickly but require frequent dosing.

    Common products, doses and duration of therapy:
    Cephalexin: 125-250mg Oral 4-6x/day for 10 days)
    Cefaclor: 250mg Oral 3xdaily for 10 days
    Cefoxitin: 2g IV daily for 1 or 2 wks

    MACROLIDES:
    These compounds are very effective bacteriostatics that work by interfering with protein synthesis at the 50S subunit of ribosomes. They are generally more effective against gram (+) organisms. They are also fairly stable in solution at or below room temp. This is one of the ABs that can be catabolic to gains if used at high doses for long periods of time, but it is generally not a problem.

    Common products, doses and duration of therapy:
    Erythromycin: 500mg Oral 3-4x/day for about 2 wks (stomach upset can be a prob)
    Clarithromycin: 500mg Oral 2x/day for not less than 5 days
    Azithromycin: 500mg Oral 1x/day for 3-10 days

    TETRACYCLINES:
    These are broad spectrum agents. Old, expired tetracycline sometimes contains a very nasty, toxic degradent that is quite kidney toxic. If the pills or powder have been stored in cold, this is not usually a problem, but when in doubt don't use old tetracycline. Other drugs in this class are not prone to the problem. These compounds interfere with 30S subunit ribosomal protein synthesis. Tets work by chelating minerals, so iron, calcium and magnesium supps should generally be temporarily discontinued while on them. Also be aware that photosensitivity can be significant, so avoid long periods in direct sunlight or take measures to cover the skin if it can not be avoided. Sunblock may be helpful. This is another AB that can cause catabolism, but once again, short courses should generally not be problematic.

    Common products, doses and duration of therapy:
    Tetracycline: 500mg Oral 4x/day for 10 days (stomach upset can be a prob)
    Doxycycline: 200mg Oral 1x/day for 5-30days (strong broad spectrum)

    QUINOLONES:
    These work on a variety of gram (-) and (+) organisms. It is cidal in that it inhibits DNA/m-RNA synthesis in an ATP-dependent manner. These are great broad spectrums, but can be toxic with extended use. Photosensitivity can occur but is generally less severe than is seen in the tetracycline class.

    Common products, doses and duration of therapy:
    Ciprofloxacin: 250-750mg Oral 2-3x/day for not less than 5 days
    Norfloxacin: 400mg Oral 2x/day for 3-30 days
    Trovafloxacin: 200mg Oral 1x/day for 2-10 days (very potent)

    LINCOSAMIDES:
    These are broad spectrums that interfere with 50s subunit ribosomal protein synthesis in a static way. They have a tendency toward pseudomembranous colitis (severe diarrhea) when used at high doses for too long. They are strong and work fast. If oral Clindamycin is combined with an equal dose of metronidazole, these sides are often avoidable. If colitis does develop, it may be wise to stop use.

    Common products, doses and duration of therapy:
    Clindamycin (base): 150mg Oral 3-4x/day for 3-7 days
    Clindamycin HCl: 150mg Oral 3-4x/day for up to 1 wk
    Clindamycin Phosphate: 300mg IV or IM 2x/day for 5-10 days
    Lincomycin HCl: 300-600mg IV or IM 1-2x/day for up to 1 month

    MISC:
    These are lesser used, or unclassified, but can still have a potential value. They all have special toxicity issues that should be investigated before attempting to use them...

    Common products, doses and duration of therapy:
    Vancomycin HCl: 500mg IV 4x/day for weeks if needed
    Cycloserine: 250mg Oral 2-4x/day for weeks or longer (often used to treat TB)
    Chloramphenicol: 250mg Oral 4x/day for 10 days
    Streptomycin: 1g IM 1x/day for weeks as needed
    Isoniazid: 300-500mg/d in one dose (often used to treat TB, acts as a MAOI so be advised)

    Note:
    To conclude, it is not as hard as one may thing to treat an abscess. The trick is to catch it fast at the first sign of infection. Drug interactions can be of concern on ABs and should be investigated prior to use. Another important consideration is to restore 'friendly flora' in the gut in between doses of ABs (with acidophilus for example) in the form of bulk powders, pills or yogurt. Taking an AB and acidophilus at the same time may nullify the AB to some degree. Remember, try not to need ABs in the first place! It is wise to use proper aseptic techniques if your doctor has you on an injectable preparation like HRT. It is important to remember that the more you use these compounds, the more resistant an organism may become. This reduces the effectiveness of the compound over time and can also compromise the usefulness of related ABs or ABs in other close classes that act by similar mechanism. And of course, always consult your doctor as to the proper use of the antibiotics prescribed to you! This is not a substitute for medical advice, just an overview of considerations.

    All info taken from the Textbook of Organic Medicinal and Pharmaceutical Chemistry, 7'th Ed.
    Last edited by DR.D; 08-06-2007 at 01:14 AM.

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    Woo-hoo! Thx Dr. D!

    Sticky, please?
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    This maybe a stupid question, but could you define the terms you used: gram (+) and gram (-)


    Also, with lincosamides, you mention the posibility of pseudomembranous colitis. Well I have Crohn's Disease, which has effected both small and large intestines. So would this be like suicide for me, or is this colitis something completely different?

    If doxycycline should be enough to knock out an abcess, why would someone even bother with Pen G? Should Pen G be used if one were to get a high fever? And doxycycline for the first signs of infection?

    Cipro is another drug I will no longer use. It messes up the good bacteria of the intestines very badly and means instant flare-up for me. Which other orals will do the same thing? Could injectables do this as well?


    Thanks and sorry for so many questions. I know there are a few other members here with similar conditions whom might find this info useful as well.
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    Gram positive and Gram negative are terms that are used to describe the cell wall composition of certain types of bacteria. Gram postive have a larger amount of a carbohydrate called peptidoglycan and Gram negative have a smaller layer of it. Using Gram's staining procedure, if they turn a purple color then they are positive and if they turn a pinky-reddish color then they are negative.
    Okay what does this really mean.. well it is just one of the ways that you can tell which baterica are which..
    On a side note penicillin works by binding to proteins involved in cell wall synthesis stopping cross-linking of glycan chains
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    Quote Originally Posted by rhinochaser48
    This maybe a stupid question, but could you define the terms you used: gram (+) and gram (-)


    Also, with lincosamides, you mention the posibility of pseudomembranous colitis. Well I have Crohn's Disease, which has effected both small and large intestines. So would this be like suicide for me, or is this colitis something completely different?

    If doxycycline should be enough to knock out an abcess, why would someone even bother with Pen G? Should Pen G be used if one were to get a high fever? And doxycycline for the first signs of infection?

    Cipro is another drug I will no longer use. It messes up the good bacteria of the intestines very badly and means instant flare-up for me. Which other orals will do the same thing? Could injectables do this as well?


    Thanks and sorry for so many questions. I know there are a few other members here with similar conditions whom might find this info useful as well.
    Gram is just a classification catagory based on an organisms color change to a std staining technique. Gram (-) bacteria (like E. Coli) cause probs because many species are pathogenic. This is usually associated with certain components of their cell walls, particularly the lipopolysaccharide layer. Most enteric (bowel related) illnesses can also be attributed to this group of bacteria. Mycobacterium are treated well with doxy and strepto, but I think there may be some newer ones designed just for Crohn's. A 5-aminosalicylate derivative if I remember correctly is giving some successful feedback. But metro kills the colitis for me, I take it with clin everytime and cipro just to be safe. You may want to avoid the clin but try stacking the metro with doxy. I like Pen G because it's cheap and effective. One shot and forget about it until the next day or 2. It's best to start with the older stuff and see if it works, then move on to the stronger stuff if needed, not the other way around. Plus, injects will mess with your intestines less than orals, just by proxy. Colitis is slower to develope. Pen doesn't have a bad rep for colitis and I have never gotten it from Pens even on long courses.
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    Quote Originally Posted by Matthew D
    Gram positive and Gram negative are terms that are used to describe the cell wall composition of certain types of bacteria. Gram postive have a larger amount of a carbohydrate called peptidoglycan and Gram negative have a smaller layer of it...
    Thanks for the back up D! I'm such a slow typer.
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    I just happened to have all that infor very handy for some reason
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    Great information.
    Link to the "abscess" thread: Antibiotics and Abscesses
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    Quote Originally Posted by rhinochaser48
    This maybe a stupid question, but could you define the terms you used: gram (+) and gram (-)


    Also, with lincosamides, you mention the posibility of pseudomembranous colitis. Well I have Crohn's Disease, which has effected both small and large intestines. So would this be like suicide for me, or is this colitis something completely different?

    If doxycycline should be enough to knock out an abcess, why would someone even bother with Pen G? Should Pen G be used if one were to get a high fever? And doxycycline for the first signs of infection?

    Cipro is another drug I will no longer use. It messes up the good bacteria of the intestines very badly and means instant flare-up for me. Which other orals will do the same thing? Could injectables do this as well?


    Thanks and sorry for so many questions. I know there are a few other members here with similar conditions whom might find this info useful as well.
    Hey rhinochaser, how ya doing? you might wanna check this out: http://www.mad-cow.org/00/paraTB.html
    Many of the antibiotics used earlier worked by blocking cell wall synthesis. But Crohn's is thought to be caused by the spheroplast form of MAP which doesn't have a cell wall; it's therefore no wonder these earlier drugs didn't work. Clarithromycin, and an antibiotic called rifabutin, have a different mechanism of action, blocking protein synthesis
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    Thanks D I know there is much more that could be added, this is good information and appreciated
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    Quote Originally Posted by Knowbull
    Thanks D I know there is much more that could be added, this is good information and appreciated
    Yes Sir, I plan on adding more, but just wanted to get some info up for now because the number of infection posts was climbing
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    Quote Originally Posted by DR.D
    ...the number of infection posts was climbing
    Was it ever! LOL. Had to do something fast right?
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    Thanks Dr. D!
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    Quote Originally Posted by Cosmo
    Hey rhinochaser, how ya doing? you might wanna check this out: http://www.mad-cow.org/00/paraTB.html

    Wow! That's a good read. That is by far the most optimistic and explanatory paper I've ever read on the subject.

    And I'm doing alright. Thanks for asking.
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    Quote Originally Posted by rhinochaser48
    Wow! That's a good read. That is by far the most optimistic and explanatory paper I've ever read on the subject.

    And I'm doing alright. Thanks for asking.

    Holy sweet mother!!!!! That is an incredible, and ballsy paper. Not only does it describe the history, the cure, as well as the explanation for it's explosion today, but unveils the political agenda of the USDA and Big Pharma.

    Damn, that's a good read. That's a real nugget you found. A real gem...
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    Thanks for the information Dr. D! I would like to offer some of my experience as dealing with these on a daily basis.
    Pen G is but sometimes can cause some pain and also not fun if you have an allergy with a big dose in your butt.
    Amoxicillin is relatively cheap and great.
    Augmentin is great but can be expensive. Plus it can also be hard on the stomach.
    Cephalexin is my favorite and works very well.
    Azithromycin is also great especially with the long half life.
    Tetracyclines are a great class except I caution if you are in the sun or using tanning booths because it can cause some sensitivity.
    Quinolones kick ass but my belief is that they should not be used first line. Dr. D mentioned toxicity but there is also some concern in the elderly and achilles tendon ruptures. It hasn't been established in young athletes however can never be too careful.
    Kudos to Dr. D and my opinion is that these are just as necessary as PCT if you are pinning. Definately worthwhile to have on hand. I've seen two nasty abscesses in the ER during training.
    knuckles
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    Quote Originally Posted by rhinochaser48
    Holy sweet mother!!!!! That is an incredible, and ballsy paper. Not only does it describe the history, the cure, as well as the explanation for it's explosion today, but unveils the political agenda of the USDA and Big Pharma.

    Damn, that's a good read. That's a real nugget you found. A real gem...
    lol yea. You gonna try the cure out?
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    Good postin' knuckles.
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    Quote Originally Posted by kwyckemynd00
    Was it ever! LOL. Had to do something fast right?
    What's up with that? Everyone just start pinning out of nowhere? I know there are a lot of good protocols on here, everyone should be in good shape
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    Quote Originally Posted by DR.D
    What's up with that? Everyone just start pinning out of nowhere? I know there are a lot of good protocols on here, everyone should be in good shape
    Well, if you want my opinion...people are stupid....simple as that

    edit: I hope I did'nt just jinx myself!!!
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    Quote Originally Posted by kwyckemynd00
    Well, if you want my opinion...people are stupid....simple as that

    edit: I hope I did'nt just jinx myself!!!
    Well, your well supplied, at least I don't have to worry about you bro! With your well conected G'F
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    Quote Originally Posted by DR.D
    Well, your well supplied, at least I don't have to worry about you bro! With your well conected G'F
    LOL. Yeah, that and the vet websites
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    Quote Originally Posted by Cosmo
    lol yea. You gonna try the cure out?
    As nice as it would be, 2 years worth of antibiotics would be a great way to destroy all my hard work in the gym, ("Farewell Protein Synthesis"). I'm not sure I'm ready for that at this point in my life.
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    Quote Originally Posted by DR.D
    What's up with that? Everyone just start pinning out of nowhere? I know there are a lot of good protocols on here, everyone should be in good shape

    This is a phenomena I've been observing quietly for awhile. In fact, it's one of the main reasons I read as much as I do:

    I find the trends fascinating.

    The influence of just a few anecdotal experiences with a new drug/method are unreal. Everyone jumps on the bandwagon.

    One of the biggest waves began with M1T. Everyone jumped on that, used it with reckless abandonment regardless of the toxicity. Later on, a group decision was made to hate it, and everyone jumped on that belief.

    Everyone began injecting when injectable PH's began selling from board sponsers. Just like with M1T, first the cautious tried it and reported good feedback, then others followed. Soon you had many homebrewing, and from there it was established, "this is the thing required to satisfy the desire for inclusion and make up for previous short comings".

    Dr. D- You've mentioned a couple drug protocols lately that I've considered to be not worth the venture based on previous acceptance:

    First would be GH releasers. Most seem to have concluded that whether they work or not at releasing more growth hormone isn't important to the end result because only chronically elevated GH is going to make any realistic difference over a short period of time.

    The other one I saw was of vanadyl. I used vanadyl extensively on and off for a couple years. I always thought it worked well and was cost efficient. I gave it up later because others believed it didn't work.

    A similar example would be DS's glucophase. I thought it was well established that only exogeneous insulin was anabolic for bodybuilding purposes. Not only that, but what's the point of sensitizing insulin if it doesn't effect what type of tissue is targeted?

    The same goes for diets and training methods, as is the case over at Lyle's board. At one time, everyone preached CKD and TKD, then it was UD2, then back to a more controlled mixed diet, and then of course the PSMF.

    The majority of readers will do whatever is popular.

    I predict, in a month or two, you'll see a lot of other 'experienced' members of other boards preaching the safe and precautious advice of always keeping antibiotics on hand when using injectables. Just as important as Nolva is.

    And you heard it here first.

    Don't get me wrong. I'm guilty of this too. Very guilty.

    Thanks again, Dr. D, for sharing here. Your experience, knowledge, and independant opinions have me thinking.
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    Quote Originally Posted by rhinochaser48
    T
    A similar example would be DS's glucophase. I thought it was well established that only exogeneous insulin was anabolic for bodybuilding purposes. Not only that, but what's the point of sensitizing insulin if it doesn't effect what type of tissue is targeted?

    The same goes for diets and training methods, as is the case over at Lyle's board. At one time, everyone preached CKD and TKD, then it was UD2, then back to a more controlled mixed diet, and then of course the PSMF.
    Endogenous is just as good if you can get it high enough. That's the trick. It is limited to what you can negotiate your body to biosynthesize. What is PSMF?
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    Quote Originally Posted by rhinochaser48
    I predict, in a month or two, you'll see a lot of other 'experienced' members of other boards preaching the safe and precautious advice of always keeping antibiotics on hand when using injectables. Just as important as Nolva is.
    If one is going to be injecting then having antibiotics should be obvious. Unfortunately, I think many individuals neglect this. The current craze of UG labs makes this even more important as clean rooms are certainly not used.

    One needs to be responsible when injecting. Having antibiotics and being aware about abscesses is part of that responsibility.
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    good posting !!
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    Quote Originally Posted by size
    If one is going to be injecting then having antibiotics should be obvious. Unfortunately, I think many individuals neglect this. The current craze of UG labs makes this even more important as clean rooms are certainly not used.

    One needs to be responsible when injecting. Having antibiotics and being aware about abscesses is part of that responsibility.
    thing is we should be telling everyone to refilter and attempt NOT to over use the antibotics..
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    those are both a good ideas matt,thats how i beleive i'll use most of the sterile ph/ps's that i have stocked[refilter into a sterile vial] before use. thanks DR. D thats a good list of antis/doses/time.
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    Quote Originally Posted by Matthew D
    thing is we should be telling everyone to refilter and attempt NOT to over use the antibotics..
    You are right. I thought the majority of this was common knowledge but obviously I was wrong.

    Using an antibiotic when it is not needed is dangerous as your body will not respond as well to future antibiotic needs.
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    Quote Originally Posted by size
    You are right. I thought the majority of this was common knowledge but obviously I was wrong.

    Using an antibiotic when it is not needed is dangerous as your body will not respond as well to future antibiotic needs.
    I added a section to the end of my post to emphasize the good points you and Matt make to try and avoid use in the first place. But at the same time, people should not hesitate to treat possible infection at the first legitimate suspicion. If it's not a real infection you know fast and can stop AB use after a few days which doesn't hurt future use. It's just a smart precaution. So keeping the proper balance is important.
  32. Pityin' fools since '81
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    allright, post of the year goes to the good dr.
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    I agree.
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    Quote Originally Posted by DR.D
    Endogenous is just as good if you can get it high enough. That's the trick. It is limited to what you can negotiate your body to biosynthesize. What is PSMF?

    Sorry, just caught this.




    PSMF = Protein Sparing Modified Fast

    It's a current craze over at www.bodyrecomposition.com.
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    Quote Originally Posted by Matthew D
    thing is we should be telling everyone to refilter and attempt NOT to over use the antibotics..

    Thing is, I've heard this from day one. Before I knew what was being talked about on the boards, I had read about filtering and heating shocking to make dirty product steril.

    I had never heard of anyone stocking or administering antibiotics, ever.

    The closest advice was, "go to the ER". Still good advice, of course.
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    Sounds interesting, thanks from the replay my man. I'm always looking for a better way to eat.

    Quote Originally Posted by rhinochaser48
    Sorry, just caught this.
    PSMF = Protein Sparing Modified Fast
    It's a current craze over at www.bodyrecomposition.com.
  37. supreme being
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    is putting an ice pack on a maybe or maybe not abcess a good idea or bad......its been over 48 hours ?and just could be a bad inject..[hit sommething] ...my temp 96.9...i know its weird but can you have a lowgrade fever with a potential abcess..lets see its a front delt i hit all three heads with 1 cc.
    and the only bad one is the front i think it was tensed up,2"x3" bloch, red ,raised up higher than my skin ,posibly a little darker around the edge.

    at this point i dont know,how much could it hurt if i wait another 24-48 hrs ?
    Last edited by WATERLOGGED; 04-21-2005 at 03:20 PM.
  38. supreme being
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    well i just waited 24hrs now the redness is gone so i guess no infection so still hurt to move it in most directions and feels a little funny so i'm convinced that i sheared a nerve thats all .but shots still make my muscle sore as ****....oh thanks to all that helped with reasuranse or helpful imfo !...bros...lol
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    Quote Originally Posted by rhinochaser48
    As nice as it would be, 2 years worth of antibiotics would be a great way to destroy all my hard work in the gym, ("Farewell Protein Synthesis"). I'm not sure I'm ready for that at this point in my life.
    about antibiotics on protein synthesis
    don't antibiotics affect bacterial ribosomes protein synthesis and not the human ribo? or do antibiotics just inhibit protein syn. in your entire body?
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    Quote Originally Posted by hikneeken
    about antibiotics on protein synthesis
    don't antibiotics affect bacterial ribosomes protein synthesis and not the human ribo? or do antibiotics just inhibit protein syn. in your entire body?
    Doxy is probably the worst, and it ain't that bad. I've used it low dose(100mg/day) for up to 2 months straight without a big problem. Effects bacteria more than you, kind of dose and strength dependent, but very over-estimated. If your laying in a hospital bed taking several g's a day of AB's, after a month you may have a problem.
  

  
 

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