Anybody take Bactrim?

[Trevgrrl]

Hi, I was just put on Bactrim, which is an anti biotic, to go with my high dose of Prednisone. Rheumatologist says it is to keep from getting pneumonia.

[HeronNS]

Why on earth would you be put on an antibiotic "just in case"? And just how high is your pred dose these days? Also, have you been ill, is there a chance you are coming down with a respiratory illness?

[DorsetLady PMRGCAuk volunteer]

Would have thought a pneumonia vaccine would make more sense as a precaution - unless you already have an infection.

[PMRpro Ambassador]

It has been a common practice in the USA for some time in patients with other forms of vasculitis - it hasn't been used in the UK until recently as far as I know. But I can't remember the details.

[HeronNS in reply to PMRpro]

When I looked it up it seems the pred helps antibiotic work better (not the other way around) and is short term. So I gather one is prescribed an antibiotic for whatever, and pred at same time to enhance effectveness of antibiotic.

[PMRpro Ambassador in reply to HeronNS]

I think this is different - it is like using an antibiotic to prevent recurrent UTIs. I wish I could work out what to search for - I have read it all up before but years ago

[MrsNails in reply to PMRpro]

Came across these articles....

pharmacytimes.com/view/when...

arthritis-research.biomedce...

[HeronNS in reply to MrsNails]

Ok. One learns a new thing every day.

[Trevgrrl in reply to MrsNails]

Thanks!

[PMRpro Ambassador in reply to MrsNails]

That's it. Sarah Mackie said she hadn't ever come across it in GCA when I asked her. I know it is used in other forms of vasculitis like GPA (formerly known as Wegeners) but whether it is standadrd practice in the UK I don't know.

[DeepThought2]

Hi Trevgrrl. I received bactrim when I was on a prednisolone dose >20 mg. It seems to be a normal practice in Germany where I am living. It is a prophylaxis against Pneumocystis jirovecci an opportunistic pathogen that can cause pneumonia under immune supression.

[Songbird69]

I was given a pneumonia vaccine as soon as I was put on Prednisolone. You only have to have it once. Better than long term antibiotics! Seems a mad idea to me!

[HeronNS in reply to Songbird69]

It seems the guilty pathogen is a fungus, not pneumonia.

[Songbird69 in reply to HeronNS]

Oh! Does that mean we should all be taking this antibiotic just in case? Not sure I would want that. Is it just for when on higher doses?

[HeronNS in reply to Songbird69]

Apparently only 20 mg and up.

[DeepThought2 in reply to Songbird69]

As said by HeronNS it is used with higher doses > 20mg (that was the prescription in my case) for longer periods (> 4weeks). And as with everything - there are pros and cons and it is always the individual balance between side effects of antibiotics and the risk of a P. jirovecii infection (which can be dangerous).

[achybreakybod]

I have been on Bactrim for 4 months now. Was put on it when I had to be bumped back up to 40 mg of prednisone. I have also started the Actemra shot. It is a precaution as my immune system is now completely suppressed and am now prone to anything that comes my way. Just don't drink any alcohol on it as you may feel absolutely horrible the next day I was told.

[Trevgrrl in reply to achybreakybod]

I was on Actemera, too, for a couple of months but developed an infection in a small wound on my leg. Took months to heal, no more Actemra for me.