GCA and antibiotics

[christine2715]

Is anyone taking antibiotics as a preventative. I have been taking three per week since April when I was diagnosed. I havn't had any infection issues. I am taking 15 tablets a day - used to be 20 so I would like to cut some out. There is so much conflicting advice from experts and I tend to trust this site more. I take azatrioprine as well and I saw on the leaflet that you should inform your doctor if you are taking the antibiotic I am takin g. I have had no rheumy for 6 weeks and I see a new one on the 17th August. I am pleased to say I have been well for two days! A real bonus for me. Now on 26 mg of Pred and slower reduction although the new rheumy still insisted I reduce at 5 mg a week having spoken only to my GP! Many thanks to everyone.

[DorsetLady PMRGCAuk volunteer]

Hi Christine,

Don't understand why you are taking antibiotics. Presumably they have been prescribed by doctor, but they are not something that should be taken without a good reason, and certainly not just as a preventative. If you do that, then there's a risk that when you actually need them to fight an infection your body will be resistant to them.

[christine2715 in reply to DorsetLady]

The rheumatologist prescribed them at the time I was diagnosed. There wasnt a reason to prescribe them except as a preventative and now I have had them for 4 months I am wondering if I should still have them. I will ask the new rheumy on the 17th.

[DorsetLady PMRGCAuk volunteer in reply to christine2715]

Like the others, I would suggest you check at next appointment if really necessary. Don't think it's normal practice for GCA patients.

[PMRpro Ambassador in reply to christine2715]

Preventative for what? I've never read anything about abx being used in GCA and it isn't common practice in GCA. I have discussed using abx in PMR with one of the top PMR/GCA people in the UK and it was clear it isn't done as a rule. The wife of a colleague of mine had been on abx of some sort when she had what was probably PMR and developed severe pred side effects - and a lot of people have commented that they felt far better while on an antibiotic than without.

[bowler]

Not sure why you need antibiotics, if you don't get/have any infections

I am at the moment on antibiotics but for a urine infection, e.coli [ I also have stage 3 kidney disease ,so I do have frequent infections ] Any infection will raise the ESR and CRP. and make you feel unwell, In the past I have been told to up my steroids because of the raised ESR CRP when all I needed was some antibiotics for the UTI. Steroids can mask infections, so some of my urine tests [ dipsticks done by the nurse ] were showing clear, apart from microscopic blood which is usual for me. Makes me wonder if I should be on a small dose of antibiotics as a preventative of frequent UTI's, which always raises my inflammatory markers, and seems to set off my GCA but like I said I do have kidney disease.

Perhaps something showed up on your blood /urine test ? that warranted the Dr. to prescribe them, you need to ask him.

[AMG38 in reply to bowler]

My Doctor put me on a low dose antibiotic 2 years ago after recurrent urine infections, ( I take one every night) and since then have not had infection. Getting down on steroids slow method to 8 - 7 mgs hoping it will work this time!

[Hidden]

Hi Christine,

The prescribing of prophylactic antibiotics is quite common with other variants of Vasculitis, especially ANCA associated types , where patients are generally treated initially with Chemotherapy. It's mainly co Trimoxazole that's used to protect against an atypical form of pneumonia called Pneumocystis jiroveci Pneumonia which immunocompromised patients are susceptible to.

That said its unusual to be prescribed antibiotic prophylaxis for GCA unless there is a specific reason such as repeated infections or immunodeficiency. I would definitely check with your new Rheumy.

[Celtic PMRGCAuk volunteer]

Christine, I agree with the others. I had both PMR and GCA but was never prescribed antibiotics, and I've never heard of anyone else having antibiotics prescribed in this way with GCA. They should be reserved for when really needed.

Also, always check with a good pharmacist before taking any medication, including antibiotics, alongside steroids and, in your case, Azathioprine as well, for any possible interaction between them all. It might be that your rheumy feels that you need some sort of extra protection due to the Azathioprine as it has the potential to affect the blood count with fewer blood cells being made so could add to the infection risk. Best to check it all out at your next appointment.

[Doralouise77]

I have not heard of antibiotics being prescribed for PMR/GCA, but have read several papers on the use of anti-fungals along with the Pred, to do with TABs showing a high percentage of the herpes that causes shingles.

Cheers