prednisone and antibiotics

[Cycles4fun]

Has anyone had a problem with antibiotics wiping out prednisone. Was down to 2.5-lowest in 8 years. Took antibiotics (Bactrim) and all old PMR symptoms came back. Hurt all over. Read Bactrim and Cipro are quinolones and do not work well with Steroids. Neither Dr or pharmacist knew this. Not sure how high I should go. Any suggestions?

[PMRpro Ambassador]

Bactrim isn't a quinolone - cipro is. Bactrim is a mix of a sulpha drug and a folic acid inhibitor. It is routinely used alongside pred in patients on high doses of steroids to prevent a serious form of pneumonia. Cipro shouldn't be taken with steroids - it can cause tendinitis on its own, the risk is much higher with pred.

I think it is more likely that the infection you are taking the antibiotic for has prodded the immune system than that the abx have caused the problem. How much pred? I suppose this is a flare situation - add 5mg to the dose where you have flared for up to 7-10 days and then you can drop back to the old dose without tapering.

[Cycles4fun in reply to PMRpro]

Thank you.