Antibiotics whilst on Pred????

[Fieldofdreams]

Hi all, please can I ask for some advice. Been struggling with a large back molar fire 6mths with an abscess. Finally it had to come out 7 days ago. The dentist said it had a lot of infection under it and wanted to give me anti biotic but remembered I was on pred (now down to 7mg) so didn't. The infection is still very much there and feels worse than when the tooth was there and in a lot if pain. What are the hazards of anti bs on Pred? Desperate to get rid of this pain. Thank you. FOD

[DorsetLady PMRGCAuk volunteer]

Don’t think there are any notable interactions between the two - and many on here have taken both in past.

But antibiotics do have their own issues - upset stomachs for some, but in my view a few days of that would be preferable to constant tooth ache!

[Fieldofdreams in reply to DorsetLady]

Thank you so much Dorset Lady. Going to try it.

[SnazzyD]

I would want to ask the dentist if they are happy to leave a patient who will be somewhat immunosupressed without antibiotic cover when there was established infection at the start. What about all the people who take antibiotics who are on moderate to high steroid doses for other conditions?

[Fieldofdreams in reply to SnazzyD]

Thanks SnazyD. The dentist did want to give me antibiotics but I have always been told not to take them whilst I am on pred.... chatting to dentist this afternoon. I was always told only paracetamol also. FOD x

[PMRpro Ambassador]

Not sure why he didn't give you abx, the infection is far more risky to you than mixing them with pred. It isn't a good idea to mix fluoroquinolone abx with corticosteroids but it isn't as if they are the only family of abx available! Both FQs and some steroids can cause achilles tendonitis and the risk when combined is much higher - and you don't want that I'm telling you from personal experience.

Are you maybe confusing antibiotics and NSAIDs? Just wondered since you say you only take paracetamol - NSAIDs are things like aspirin, ibuprofen and so on and even they CAN be taken with pred if you are careful.

[Fieldofdreams in reply to PMRpro]

Thank you so much PMRpro. Yes, was told no ibuprofen but was prescribed soluble aspirin at start of Pred journey but no longer take them. Yes... tendonitis journey has been terrible... and that's without mixing anything. FOD. X

[Rosbud in reply to PMRpro]

PMRpro , just read this reply and am left wondering if A weeks course of flucloxacillin has given me Achilles tendinitis ad I’m in real pain in the back of my heel and up my legs ?

[Fieldofdreams in reply to Rosbud]

I had acute tendinitis in both Achilles and still struggling 19 mths on. Mine was Pred related I am sure. I didn't take any antibiotics. X

[SnazzyD in reply to Fieldofdreams]

Me too, still struggling but much better after finding a decent podiatrist and physio who both homed in on my chronically weak hip and pelvic muscles and treated them first with good effect on the Achilles and feet that were hurting even more latterly. They had affected my gait that upset my already pretty miffed Achilles. I do also think that previous damage with Quinolone antibiotics in 2004 didn’t help and the reduction of Pred below 1mg has.

[Fieldofdreams in reply to SnazzyD]

I've got orthotics too but not fitting right yet. I've got plantar fasciitis now but hoping it will recover soon. Fed up of not being able to exercise my body. Do some yoga and gentle stretches but no dancing! X

[SnazzyD in reply to Fieldofdreams]

Oh yes, I hear you!

[SnazzyD in reply to Rosbud]

Flucloxacillin is not a Fluoroquinolone Group antibiotic. They come under names like Ciprofloxacin and Norfloxacin. Well, the -acin gives it away.

[Rosbud in reply to SnazzyD]

Thank you SnazzyD , just coincidence it’s happened at the same time x

[PMRpro Ambassador in reply to Rosbud]

It isn't an antibiotic that is flagged as a risk. Achilles tendinitis can happen with pred as you can see from the other replies.

But you need to get it looked at - achilles tendinitis does increase the risk of serious damage to the tendon if you were to trip or fall over/down a step. I had a boot and was on crutches for nearly 9 months to reduce that risk.

[Rosbud in reply to PMRpro]

Thank you so much , I’ll book to see GP and get it checked xx

[Hidden]

Might I suggest that you take a look at this article as I suspect (not diagnose) that this could be he source of your continued pain. It is very easy to dislodge the blood clot and leave the bone exposed. An idea that’s all

mayoclinic.org/diseases-con...

[Fieldofdreams in reply to Hidden]

Thank you I will have a look.

[Hidden in reply to Fieldofdreams]

Even better explanation

nhs.uk/conditions/wisdom-to...

[Fieldofdreams in reply to Hidden]

Thank you so much. It may be still infected or dry socket as it is extremely painful. Seeing the dentist in the morning. FOD x

[Hidden in reply to Fieldofdreams]

I suspect that he may just pack the socket with a topical steroid/antiseptic, possibly with antibiotics systemically. If it is what I suggest, relief will come quickly, but it is sometimes difficult to treat after the clot has been disturbed.

Good luck, it is an excruciating condition and you are coping very well.

[Fieldofdreams in reply to Hidden]

thank you so much. i am so reluctant to even let anyone touch it as its so painful.... but hopefully it will start to recover once its got something in it and I take some anti b's FOD x

[Hidden in reply to Fieldofdreams]

Good luck

[piglette]

I have taken anti biotics while on pred, I did not know that we shouldn’t.

[PMRpro Ambassador in reply to piglette]

No reason why not - just quinolone abx aren't a good idea - but they aren't a good idea anyway!

[Francesbarbara]

I had an abscess on a back molar. Had root canal treatment to save the tooth and had to take antibiotic. It caused horrid stomach problems but as soon as they were finished, all went back to normal and to have got rid of the pain was such a relief. By the way, while on antibiotic I continued with Pred of course but had to stop Metyhotrexate.

[Pixix]

I’m on second course of antibiotics for infection in large back tooth. I followed the ‘sick day rules’...see pinned post on this site, and increased my steroids. I have managed well, & my PMR is better than usual. First antibiotics didn’t work at all (erithromycin) but second antibiotics (metronidazole) are helping. Think I will still end up losing tooth next week, but happy to see if these work. I’m allergic to penicillin, hence the drugs above. Metronidazole is harsh on the stomach but I take lanzaprozole (wrong spelling, half asleep still) due to Pred intake, so I’m covered. It still hurts if I tap the tooth with tooth above but the all encompassing, dreadful toothache has gone., touch wood Hope this helps a bit, S x