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Pharmacy/antibiotics with sotalol

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Question
Hi ,

I have been on Sotalol hydrochloride (beta-cardone) 80 mg twice a day for several years, for wolff parkinson white symptom relief. My concern is that I am allergic to penicillin and have always had heart worsening palpitations when I have had infection or antibiotics. I now discover that I should not have been on some of these for uti or general upper resp infections as they are unsafe with sotalol eg erythromycin etc. can you advise which broad spectrum would be safest to request from my doctor in future please, as they don't seem to realise the risk or unpleasant symptoms I get ? Thank you

Answer
Elizabeth

Ideally the antibiotic chosen should suit the condition being treated and follow local guidelines for treatment produced by microbiologists. These protocols will usually have alternative options to cover problems such as penicillin allergy, and your GP should be aware of them.

Erythromycin is viewed as a high risk drug when taken with drugs such as Sotalol, but it may be necessary to use it if there is no suitable alternative (based on lab results etc.). Other options depending on the type of infection would be:

Trimethoprim - UTI
Nitrofurantoin - UTI
Doxycycline (or other Tetracycline) - Resp. infections


It may also be possible to use a cephalosporin such as Cephalexin. There is a small proportion of patients who are allergic to penicillin and cephalosporins, but the majority are not. Depending on the severity of your penicillin allergy (and if it is a true allergy rather than a stomach upset), your GP may be prepared to try a Cephalosporin, or if they are concerned it is possible to have allergy testing performed.

I hope this helps.

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Nigel Simmons

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I am happy to answer general questions on medicines and hospital care. If possible, please use approved / chemical names rather than brands which are not internationally recognised. Like all health professionals I am bound by a duty of care which prevents me giving detailed information about medication or treatment of people other than the questioner. I will endeavour to help wherever possible or point towards more appropriate advice. If however your question crosses too far into patient confidentiality, I hope you will understand why I cannot answer your question. Consider.. would you want me to discuss your care with a friend or relative without your knowledge?

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