Antiobiotics and prednisone ? Does anyone know if antibiotics are prescribed/congestion, fever, while you are on pred?

Have bad flu-like symptoms, going into the fourth day. They are not getting better with usual ibupropren and other OTC remedies. Am still dealing with fatigue (from the prednisone). In the past, before being on the methylprednisolone, after a few days, and colored sputum (which I have), the doctor would prescribe antibiotics. Has anyone gone on a course of antibiotics, while on prednisone ? Will google it, for dangers, and side effects. Thanks. best, Whittlesey

27 Replies

  • I have had an antibiotic for a sinus infection and also for a urinary tract infection while I have been on prednisolone. The doctor wasn't concerned. If your sputum is as nasty as you describe, you should really be asking your doctor.

  • Thanks, Annodomini. I've never heard anything negative about antibiotics and prednisolone. will check with the doctor. thanks,

  • Yes, I've had antibiotics a number of time for various reasons, including some 'heavy duty' anti-bs for a severe chest infection. I've never had any problems.

  • Thanks Polkadotcom. good to know. I think this is becoming 'severe'. will speak with the doctor. best,

  • I have been on antibiotics a few times with no problems.

    The one big NO is combining antibiotics from the quinolone group and pred, especially Medrol. Both quinolone abx and medrol/methylprednisolone on their own can cause problems with inflamed achilles tendons, combining the two makes it pretty likely. This isn't a theoretical risk - it happened to me 2 years ago and the sequelae were fairly unpleasant overall! An inflamed achilles tendon is at high risk of rupturing and a ruptured achilles tendon is a major problem to sort. Just tripping a bit on a kerb is enough to snap it - requiring major surgery.

    This is in fact a persisting problem - having been on methylpred it is better never to take quinolones in the future. For some unknown reason the risk remains.

  • Thanks, PMRPro. will let the doctor know. With the achilles tendon, will be careful. I do have plantar fascitis in both feet. It happened in the late '90's -- -- walking the blocks in NYC to work, to the bus, for a second job, after overtime, different buses home, different blocs. I had to walk up an incline to my apartment, then. I began to feel "something" in my left foot. A few days later, it felt like someone had pulled my foot apart. My insurance in those years was not that good and expensive. I tried putting an ace bandage on it and going to work. After a few hours, it was horrible. Went to a Sports Medicine doctor. He did either an x-ray or a scan, I don't remember which. and yes, the films showed I had plantar fascitis. He said sometimes it takes a year to get over it. Was soaking in hot tubs. Very difficult. Now it is sometimes painful. I am careful how I walk. Do not want to activate that. Thank you for your advice. best, Whittlesey

  • Thank you, PMRpro. will be careful with this.

  • Antibiotics no problem with preds,I had 2 lots of them both together for my embolisms in my left lung and multiple fractured in spine .dont worry about them i have not heard anything

    bad about taking both together,good luck Anne

  • Possibly not with most Anne - but methyl prednisolone and quinolones together is a serious risk. It doesn't have to be at the same time - if you have a history of taking methyl pred, don't ever take a quinolone. I'm not scare mongering - it is documented and doctors "know", but don't always put 2 and 2 together.

  • Hi PMRpro sorry but what is methyl prednisolone?and quinolones I have nor heard of that before, gosh i have such a lot to learn,don't know if my little brain can take all this in it is mind boggling,hope you are well and thanks for reply kind regards Anne.

  • Methyl prednisolone is a slightly more modern form of prednisolone, it has a slightly different chemical formula and is supposed to be more effective at reducing inflammation. It isn't used a lot in the UK I don't think except as injections and for the high dose infusions in GCA or other similar problems. In the USA and here in Italy (don't know about other European countries) it is used as the equivalent of the plain common or garden pred used in the UK.

    Quinolones are a group of broad spectrum antibiotics including Cipro which is used in the UK. The substance names (as opposed to the brand names) usually end in - oxacin. In the UK they tend to be used for more severe infections - but here in Italy I was horrified to find they are used for urinary tract infections. They are powerful - but resistance develops very quickly and some are already of little use for children's ear infections where they were overused, for example. Mixing them with corticosteroids can cause problems.

    It's because most of us don't have the background to know these things that we tell you again and again - never take anything, prescribed or OTC, without checking with the pharmacist first that it is OK together with anything else you are already taking - again both prescribed and OTC, even supplements.

    As Sambucca says - ask the pharmacist, not the counter staff and probably not your GP who isn't anywhere like as well trained in pharmacology as your pharmacist. Personally I like to see them look it up, just in case, because new information comes out all the time. I know how to look on the internet - because I use pharmacy sites for professionals and from the manufacturers - but unless you can tell which is serious medical science and which is woo you are better checking with the pharmacist.

  • I have been looking at, which is a pretty reputable site in the U.S. They say that the cortersteroids and quinolones, if taken together, will have side effects, including tendon problems.


    Azithromycin is a "macrolide", it has been explained. According to this site, taking azithromycin with medrol -- the body will not properly process medrol and unsafe amounts will build up in blood. They speak of inflammation, trouble breathing and other side effects. It is 6:20pm, now. I will call my doctor tomorrow. The ER doctor did not understand what I was saying. There may be something else which can treat bacterial pneumonia.


  • Once again I repeat myself.

    Whenever you are on drug which is prescribed for you and you take it to your Chemist, ask to see the Pharmacist and it must be the Pharmacist. Ask them to check compatibility with any other drug you are taking and this includes OTC and/or Homeopathic drugs.

    You should not buy OTC or Homeopathic remedies without checking with your Pharmacist, they are the ONLY people who understand drugs and interactions.

    Trust your Pharmacist and ask the questions.

  • Hi Sambucca, If I don't hear from the doctor, I will call the pharmacist. He was busy this morning, to speak with me. He did print out the list of "Patient Education" risks, side effects. I have read them and found nothing about not using this with medrol. will wait though. best, Whittlesey

  • I'm on antibiotics for a skin infection, the doctor knows I take cortisone and didn't mention any conflict. I'm on Medrol and am rather alarmed to hear about them not being compatible with antibiotics, especially as I have Achillies tendon problems!

  • Have just checked, and I am on penicillin, hope that's OK.

  • The quinolone group of antibiotics that PMRpro mentions are ciprofloxacin etc. Penicillin is a different group and is ok.

  • Yes - it is only the quinolones that cause this problem. I simply bear it in mind and if I am told I am to be put on antibiotics I TELL the GP I won't take quinolones and please make sure it isn't one. I get looked at by some but I don't mind - I spent a long time on crutches and was very ill as a result. Not going there again!

  • Yes I have I went for flu jab in November Nurse called Dr out of her surgery as my feet and legs swollen and red Dr thought it could be cellulitus and prescribed fluxacillin (not sure about spelling )but it was for soft tissue infection. .Had been to see Rheumy for 1st time and had put on a stone lost 12 1/2 pounds in a week I thought it was due to pred but specialist nurse and my doctor said antibiotics. Cant say about any other antibiotic Hope this helps hope you feel better soon Take Care

  • Thanks, Tweetiepie. It does help. My rheumatologist has told me that I have Reynauds in my hands and feet -- that they have a reddish tone (which is hard for me to see). She thinks there is a connection to GCA with this. I have been using a good lotion for both and haven't had time to look into this. I'm glad it worked. all my best, Whittlesey

  • I have GCA/PMR

    I also have stage 3 kidney disease, and have frequent urinary tract infections.

    I was recently prescribed the antibiotic Trimeothprim which gave me awfuful headaches, and seemed to aggravate my GCA ?

  • Thanks, Bowler. I also have GCA. Before I took the azithromycin, I noticed a different prominent artery - ? sort of pulsing out wards in my forehead, near my hairline. This is new. At the beginning of finding out about GCA, I had both arteries on each temple "out" -- which is a sign of GCA. No longer. and now after taking the azithromycin, the artery is no longer "out". and the headache I had yesterday, is gone. The side effects, may work both ways -- possibly reducing the inflammation or aggravating it. ? I don't know that much about antibiotics --- nor how they react with medrol. Thank you for your reply. all my best, Whittlesey

  • The azithromycin will raise the pred level in your blood - the same as being on a higher dose. I can't remember what dose you are on but maybe that your GCA may be flaring and the azithromycin has helped. by effectively increasing your dose for you.

  • It is possible that there was some GCA flare with this. Would rather have that treated with medrol that can leave the body, without staying in the liver. Apparently the az prevents the pred from leaving the liver, which can't be good. Part of the warnings on the az, say that there can be liver problems and darkened urine is an indication. have had the darkened urine. not so much today.

  • I'm very interested in the link between Medrol and Achillies tendon problems, I've been on Medrol for four years and have had quite serious Achillies tendon problems as well as plantar fascitis both of which have been almost completely resolved by a combination of exercises and inserts from a podiatrist. If you google "Medrol + Achillies tendons" you get a lot of information about how it is used to treat Achillies tendon injuries!

  • It may help. I, also have not had too much trouble with the plantar fascitis, since taking medrol. However, from what I understand, too much medrol or prednisone can begin to cause damage to the tendons and muscles. Reason to keep it at as low a dose as possible, it would seem. Can also affect the bones and may lead to osteoporosis, I understand. am taking alendronate for prevention, due to the medrol. not taking it this week, due to the az. will be speaking to my doctor. thanks. all my best, Whittlesey

  • I was banned from taking Ibuprofen and any other NSAID whilst on Pred. I have also read that NSAID's should not be taken by anyone over the age of 60. They can cause serious stomach disorders especially if taken when the patient is on steroid treatment which is an anti inflammatory in its own right.

    I have just taken a course of antibiotics for kidney infection (medication induced of course) and had no problems apart from a bit of thrush which I have never had before.

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