I am a 20 year old female and am studying abroad in Peru and dont have access to a clinic or hospital at the present but somehow get internet on my phone.  For the past 11 days I have been taking doxycycline(100 mg daily) as I am in a malaria infected area of the country.  Yesterday I began having symptoms of strep throat, which I have been prone to get my whole life and I am in constant contact with a large group of children.  Today my symptoms worsened, I have a fever of 102 degrees, have a bright red throat, and swollen lymph nodes; and without thinking I took amoxicillin(500 mg) this evening-about 10 hours after I took doxycycline this morning.  So my first question is what should I do, continue taking doxycycline to prevent getting malaria or take the amoxicillin to get rid of strep throat? Obviously I would rather have strep than malaria, but is there some other antibiotic I could take?  My second question is about the side effects of doxycycline.  As I was concerned about the previously stated drug interaction, I began looking online and also discovered that vaginal itching is a side effect of doxycycline as well.  I only started noticing vaginal itching this morning and I dont know if this is a serious side effect and what you would recommend for me to get rid of it.Thanks!
Hi there, I understand your predicament when you have limited access to medical care.  To answer your first question, yes continue taking both antibiotics.  They are from different groups of antibiotics, and tackles different kinds of infection.  The only catch is that doxycycline has been known to reduce the effectiveness of amoxicillin, but I would not have you stop the doxycycline and expose you to the malaria risk.  Go ahead with the amoxicillin if that is what you have on hand, and make sure to complete the full course.  If you find that indeed the amoxicillin doesn't work so well this time (you will be able to tell after 2-3 days), see if you can get antibiotics from another group, like erythromycin or cefuroxime. The answer to the second question is that no, it is not a serious side effect.  It is probably just a yeast infection, also called candida, and is a common side effect of any antibiotic, because it kills off the natural bacteria in the vagina.  You will need to get some antifungal pessaries like clotrimazole to insert into your vagina, or if you prefer oral medication for any reason at all, something like fluconazole will help.  Do not worry excessively about this if you can't get medication for this urgently, it is simply a nuisance condition that does not have long term problems. Hope this helps, and all the best to you.