Expert: Mark Bornfeld DDS - 3/12/2009

Question
QUESTION: Hi, I got a message today from AllExperts which only said "You are welcome" at the top of the message, with usual format being reply at the bottom of the message. Also didn't say Dr. Bornfeld signature under "You are welcome". So I was a bit confused if it was from you. Soon after I got another message from AllExperts which said "For some reason your message did not get answered, please repost". I did not re-post my message because I thought it was maybe a glitch in AllExperts system. So am just asking if it was you who wrote "You are welcome" at the top of your reply to me.

ANSWER: Dear Kate,

It had seemed to me that your last message did not contain a question, but simply an acknowledgement of my previous reply; you also closed your message with "thank you".

Although I did not manually write "you are welcome", the AllExperts reply form has an option to send a "thank you" note, which is the option I selected. Does that clarify things?

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY

---------- FOLLOW-UP ----------

QUESTION: Hi,This should be the message you never received which I have re-typed.:

There has been much publicity for past few years about antibiotic resistance.So most doctors now and dentists (first time I've had prescrip.from a dentist) are more prudent about prescribing them especially for viruses which are not helped by antibiotics as in link you gave me.   

Yes, I know clindamycin can cause dangerous colitis.I do a lot of Internet research re medical re medical issues which interest me, and found several interesting medical articles about several anti bacterial drugs including clindamycin, which showed that some similar anti bacterial drugs can also have risk of pseudo membranous colitis, which is a scary thought.But I agree you have to be careful with clindamycin (it gets the most publicity about colitis), but perhaps others of same class of drugs, and not be on them longer than necessary.

I decided to phone my dentist and have appointment tomorrow.
I want him to check the lump on my cheek and tell him my 7 day treatment of antibiotics are done. And my tooth is still a bit sore. Its more for reassurance than anything.

Here are two links I found re studies of clindamycin and other anti bacterial drugs,which you may find interesting reading. You may have to copy and paste.

http://www.austdent.com.au/clindam.pdf

I had a problem accessing above site the second time I went, but next time was OK.

http://www.merck.com/mmhe/sec09/ch127/ch127a.html

Would you mind letting me know if you get this message this time? Thanks.


ANSWER: Dear Kate,

Thanks for those links-- they provide interesting context for the current problem of antibiotic resistance and the CDC initiative.

Good luck on your upcoming dental appointment!

Mark Bornfeld DDS

---------- FOLLOW-UP ----------

QUESTION: Hi, short message this time and probably my last.I didn't see anything about CDC initiative in any of the above two links. Was that info in the link of the study site? The Merck site was mainly about anti bacterial medications which could cause C-difficile.Just curious, may I ask had you heard of other drugs besides clindamycin which could also cause pseudo membraneous? Thanks.

Answer
Dear Kate,

The CDC information was not referenced by either of the sources you cited.

Yes-- it is well established that almost all antibiotics-- especially those with a broad spectrum of activity-- can disrupt the normal balance of digestive tract flora and lead to opportunistic infections such as candida albicans and clostridium difficile. However, this effect is more forcefully presented in the official prescribing information for clindamycin than other drugs.

Mark Bornfeld DDS