Prednisone's effect on anti-bioitic effectiveness

[Alex]

My son is currently on an extended course of prednisone and is also taking 250mg of azithromycin daily. Does anyone know to how large of a degree prednisone lessens the effectiveness of antibiotics? I have read that becuase prednisone represses the immune system, it makes it more difficult for antibiotics to do their job aiding the immune system to kill bacteria. Alex

[Buster]

Technically, the antibiotics will still work (i.e., slowing the protein copying activity in the case of azithromycin) but the bodies own immune system is suppressed on prednisone. So, if there is a present strep infection, it'll be held in check, but the immune system will be slow in doing anything about it. I'd be hesitant to be on long term prednisone -- given all the side effects there (including the one you highlight). A short term burst helps break cycles of inflammation and over response by the immune system.

 

There is a very, very recent paper out http://www.ncbi.nlm.nih.gov/pubmed/1989668...mp;ordinalpos=1

 

That has been looking at this treatment. You might want to look at their findings (albeit on just a single case).

 

Regards,

 

Buster

 

 

My son is currently on an extended course of prednisone and is also taking 250mg of azithromycin daily. Does anyone know to how large of a degree prednisone lessens the effectiveness of antibiotics? I have read that becuase prednisone represses the immune system, it makes it more difficult for antibiotics to do their job aiding the immune system to kill bacteria. Alex

[peglem]

Technically, the antibiotics will still work (i.e., slowing the protein copying activity in the case of azithromycin) but the bodies own immune system is suppressed on prednisone. So, if there is a present strep infection, it'll be held in check, but the immune system will be slow in doing anything about it. I'd be hesitant to be on long term prednisone -- given all the side effects there (including the one you highlight). A short term burst helps break cycles of inflammation and over response by the immune system.

 

There is a very, very recent paper out http://www.ncbi.nlm.nih.gov/pubmed/1989668...mp;ordinalpos=1

 

That has been looking at this treatment. You might want to look at their findings (albeit on just a single case).

 

Regards,

 

Buster

 

 

My son is currently on an extended course of prednisone and is also taking 250mg of azithromycin daily. Does anyone know to how large of a degree prednisone lessens the effectiveness of antibiotics? I have read that becuase prednisone represses the immune system, it makes it more difficult for antibiotics to do their job aiding the immune system to kill bacteria. Alex

Buster, in that paper, they talk about Psychogenic and Organic movement disorders. What is the difference?

[Buster]

Buster, in that paper, they talk about Psychogenic and Organic movement disorders. What is the difference?

 

The term "psychogenic" refers to movement disorders that seem to respond to psychotherapy, placebo, are not consistent (implying some form of voluntary participation/choice), or seem related to a psychiatric illness.

 

The term "organic" refers to, well, tics, tremors or other sterotypies (implying non-choice).

 

Essentially the authors are trying to classify those movement disorders that respond to psychotherapy (or placebo) and those that do not.

 

I can't tell you if these terms are used pervasively. One of my old professors used to say that most PhDs are granted on the achievement of a student to overcome their own terminology -- a kind way of saying that sometimes the terms sound good on paper but have limited use :-)

 

I referred to the paper because they did use a combination of antibiotics and steroids and it was an interesting recent case study.

 

Buster

[Kayanne]

Buster,

 

What would you consder long-term prednisone?

 

We are currently not seeing any PANDAS, however, Dr. Latimer feels that we should be able to control it in the future with steroid use. I wrestle with idea of risks vs. benefits, and where to draw the line on giving it.

 

I can't seem to find much more about it on the internet, but the general info...what exactly is it doing? how long before the immune system is suppressed? what about giving it while the body is trying to fight an infection? what exactly is considered short term?

 

If you have come across anything with regards to this info, I would appreciate it if you could post the link.

 

thanks!

 

~Karen

[Buster]

Hi Karen,

 

I'm not an expert on this topic. Perhaps one of the members who has multiple sclerosis or knows someone with MS can comment. The topic is really well discussed in that forum and I think they'll have a really reasoned opinion there.

 

In general, I understand anything over a month is considered long term and requires a careful taper to avoid lots of nasty withdrawl issues. Prednisone is used in MS to help close the BBB. It has all sorts of side effects not the least of which is that sustained high-dose use necessary for significant anti-inflammatory seems to weaken bones. The papers I've found on longer term pred use are all in the MS, Lupus, athsma, or rheumatoid arthritis space.

 

Not sure what to say here, but presume your doctor is well versed in the risks/benefits. Not sure where to draw the line either. We personally were okay with a short burst (5 days) but were worried about some of the longer term effects.

 

Regards,

 

Buster

 

Buster,

 

What would you consder long-term prednisone?

 

We are currently not seeing any PANDAS, however, Dr. Latimer feels that we should be able to control it in the future with steroid use. I wrestle with idea of risks vs. benefits, and where to draw the line on giving it.

 

I can't seem to find much more about it on the internet, but the general info...what exactly is it doing? how long before the immune system is suppressed? what about giving it while the body is trying to fight an infection? what exactly is considered short term?

 

If you have come across anything with regards to this info, I would appreciate it if you could post the link.

 

thanks!

 

~Karen