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Z pack and prednisone. The Efficacy of Prednisone and Azithromycin in the Treatment of Patients With Cat Scratch Disease |
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In our latest question and answer, our pharmacist discusses whether or not prednisone can safely be taken with azithromycin. I had COVID 6 days of moderate symptoms and was prescribed azithromycin, prednisone, famotidine, and fexofenadine, for allergies. Can I take all these together? Also, is it better to wait and start prednisone after the Z-Pack since affects some antibiotics? Don't want to decrease the effect of antibiotics.
Answered by Dr. All the drugs you listed in your question azithromycin, prednisone, famotidine, and fexofenadine are considered safe to take together as there is no reported interaction between them.
I certainly understand your concern here with taking prednisone. Prednisone is the most commonly prescribed corticosteroid, and corticosteroids, as a class of drugs, are associated with immunosuppression , which is why you've probably heard not to take them with antibiotics since you are treating an infection with those. Additionally, several studies have noted that individuals taking corticosteroids consistently, at high doses to treat certain inflammatory conditions such as rheumatoid arthritis, Crohn's, and ulcerative colitis are more at risk for certain infections due to the immunosuppression prednisone causes, namely:.
Having said all this, the dose of prednisone you are taking and how long you are taking it is highly relevant. Although taking prednisone at any dose and duration can increase the risk of infection, generally, those who take high doses, consistently, are most at risk what a 'high dose' of prednisone is varies by source, but is generally around 40mg or more per day. Combining an antibiotic with prednisone for short-term treatment of a condition is really a question of if the positives outweigh the risks.
Azithromycin and prednisone are very commonly prescribed together for the short-term treatment of conditions like sinusitis and bronchitis since the benefit of therapy generally outweighs the risk of complications from the combination. In fact, one of the most commonly prescribed combinations of medications used for the short-term treatment of sinus infections is a Medrol Dose Pack which contains methylprednisolone, a similar steroid to prednisone and a Z-Pak azithromycin. Several studies have published results showing preliminary positive benefits with short-term use of the combination:.
The point here is that, yes, there are concerns with taking a corticosteroid and how it can suppress the immune system, which increases the risk of infection. However, for many individuals, a short-term course, at a relatively low dose of a steroid, is considered safe, with the benefits outweighing the risk.
It is more commonly those that are taking steroids on a daily basis, or at high doses or both that we are more concerned about. So, overall, there is no specific interaction between azithromycin and prednisone, and the drugs don't interfere with one another. It's the conflict between immune suppression and treating an active infection that is the concern. As everyone's medical situation is different, I recommend talking to your doctor about what makes the most sense for you.
Brian has been practicing pharmacy for over 11 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Feel free to send him an email at Hello HelloPharmacist. You can also connect with Dr.
Brian Staiger on LinkedIn. What medications can one take while on the medication warfarin for chest congestion and cough? Facebook Email Twitter Copy Link. Question I had COVID 6 days of moderate symptoms and was prescribed azithromycin, prednisone, famotidine, and fexofenadine, for allergies. Asked by Lane On Aug 13, Published Aug 16, Last updated Aug 16, Answer Thanks so much for reaching out to us and I hope that you are feeling better!
You specifically mentioned azithromycin and prednisone, so I do want to focus on that part. Azithromycin With Prednisone I certainly understand your concern here with taking prednisone. Additionally, several studies have noted that individuals taking corticosteroids consistently, at high doses to treat certain inflammatory conditions such as rheumatoid arthritis, Crohn's, and ulcerative colitis are more at risk for certain infections due to the immunosuppression prednisone causes, namely: Common viral infections e.
Staphylococcus aureus Common fungal infections Candida species Having said all this, the dose of prednisone you are taking and how long you are taking it is highly relevant. Several studies have published results showing preliminary positive benefits with short-term use of the combination: Current evidence suggests that oral corticosteroids as an adjunctive therapy to oral antibiotics are effective for short-term relief of symptoms in acute sinusitis The point here is that, yes, there are concerns with taking a corticosteroid and how it can suppress the immune system, which increases the risk of infection.
Final Words Thanks for your question and please feel free to reach back out in the future! Was this article helpful? About the Pharmacist Dr. Brian Staiger, PharmD Dr. Still Confused? Ask the pharmacist a question here! Recent Questions. Nov 21, Magnesium Citrate Alternative Options Magnesium citrate in liquid form is not available Nov 17, We'll never share your email with anyone else.
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❿- Z pack and prednisone
Z pack and prednisone. Steroids and antibiotics prescribed together: New trend?
As with most drugs, the generic versions cost less but still comprise the same substances. Methylprednisolone is stronger than prednisone:. Prednisone is an oral medication that people take in the form of a tablet, liquid, or concentrated solution.
People will take between one and four doses a day depending on the medical condition and the effectiveness of the treatment. In many cases, a doctor will inject methylprednisolone into either the muscle or vein.
However, for certain conditions, such as RA, they may sometimes inject methylprednisolone directly into a joint to reduce inflammation. Being injectable makes methylprednisolone easier than prednisone to provide in large doses. Both prednisone and methylprednisolone are very strong medications. Doctors will try to use the lowest possible dosage that is effective, so they may increase or decrease the dosage during treatment.
People who stop taking them too quickly may notice side effects, such as:. As methylprednisolone and prednisone are both very potent, they can cause a range of side effects, including:. The side effects of prednisone can also include losing touch with reality. For this reason, doctors may prescribe methylprednisolone to someone with a risk of mental health conditions instead of prednisone to reduce the risk of psychosis.
Due to these side effects, doctors may avoid prescribing these corticosteroids. They may only recommend them if nonsteroidal anti-inflammatory drugs NSAIDs are not effective or if a person has severe inflammation. Corticosteroids can interact with many other medications, including some nutritional supplements and alternative medicines, such as herbal remedies.
Before using corticosteroids, a person should tell their doctor about any other medications that they are taking. Corticosteroids have a widespread effect on the body. As a result, they can cause complications, some of which are severe. Taking corticosteroids for more than a month, which doctors consider long-term use, increases the likelihood of adverse effects occurring.
It is important to note that these drugs can reduce the activity of the immune system, which makes it harder for the body to fight infection. Complications are more likely to affect people who have or have had certain medical conditions, such as:. Methylprednisolone and prednisone are corticosteroids that can have a significant impact on the body.
They are effective medications for reducing inflammation. Both medications can produce a range of side effects and complications. Methylprednisolone is more potent than prednisone. Doctors can give methylprednisolone orally or through an injection, while prednisone is only available as an oral treatment. Methylprednisolone may, therefore, be more appropriate for people with digestive issues that stop them from taking or fully absorbing oral drugs.
Can you tell me if this dual prescribing is a widespread medical trend or just a local one? Is there really a good reason for prescribing antibiotics and prednisone together, and am I being foolish not to follow doctor's orders? Dear E. These studies have shown a speedier recovery in those taking the combination of steroids and antibiotics than in those who take antibiotics alone, and I suspect that is why your doctors, and those of your friends, have been prescribing them.
However, there is a downside to steroids, as you note. It's not just the unpleasant immediate side effects, such as jitteriness and difficulty sleeping; steroids can have serious side effects in the short term confusion and even psychosis are well known. In the long term, the list of possible side effects is very long, so the benefit must always be weighed against the possible harm.
This is particularly the case in people at high risk for side effects, such as diabetics in whom sugar levels routinely go up when taking steroids or those with high blood pressure which often is exacerbated by steroid use.
Personally, I prefer to use nasal steroids in combination with antibiotics. They have many of the benefits of oral steroids with few of the side effects. Recruitment status was: Not yet recruiting First Posted : November 10, Last Update Posted : November 11, View this study on Beta.
Study Description. Corticosteroids may be effective in the treatment of CSD for the following reasons: Many experts believe that host response is involved in the pathogenesis of CSD and is responsible for the clinical manifestations rather than the direct effect of B. The absence of viable organisms in affected lymph nodes in the presence of positive PCR for B. Corticosteroids have been anecdotally reported to have been administered to patients with CSD, apparently with some success.
The purpose of this study is to evaluate the efficacy of corticosteroids in addition to azithromycin in CSD. The study hypothesis is that corticosteroids will improve out come. Patients will be under followed up for 3 months. Major outcome measures will include duration of symptoms and signs, with particular emphasis on affected lymph node size and duration using a specific scoring system lymphadenitis score, LS. LS will be used to evaluate lymphadenitis at each follow-up visit.
The historical control group will be consisted of age, sex, and clinical manifestations-matched CSD patients who were treated with azithromycin without corticosteroids. Drug Information available for: Azithromycin Azithromycin dihydrate Azithromycin monohydrate. FDA Resources. Arms and Interventions. Intervention Details: Drug: prednison and azithromycin Patients with typical cat-scratch disease will be treated with a 5-day course of prednison and azithromycin.
Outcome Measures. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Ability and willingness to comply with the protocol. Male and female patients aged years at the time of signing informed consent. Patients with clinical manifestations consistent with early typical cat scratch disease lymphadenitis before spontaneous improvement has been recorded and before development of suppuration.
Study record managers: refer to the Data Element Definitions if submitting registration or results information. Bartonella henselae is the etiologic agent of cat scratch disease CSD. In most CSD cases resolution occurs in 2 to 3 months although a prolonged course often occurs. Data on the efficacy of antibiotic therapy in CSD is limited.
Azithromycin has been shown to have a small favorable effect in a small comparative study and is commonly prescribed for CSD, however its overall effect is not satisfactory. Corticosteroids may be effective in the treatment of CSD for the following reasons:.
The total score will consist of the arithmetical summation of the 5 parameters. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. We're building a better ClinicalTrials. Check it out and tell us what you think!
Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies The Efficacy of Prednisone and Azithromycin in the Treatment of Patients With Cat Scratch Disease The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Listing a study does not mean it has been evaluated by the U. Federal Government. Read our disclaimer for details. Recruitment status was: Not yet recruiting First Posted : November 10, Last Update Posted : November 11, View this study on Beta.
Study Description. Corticosteroids may be effective in the treatment of CSD for the following reasons: Many experts believe that host response is involved in the pathogenesis of CSD and is responsible for the clinical manifestations rather than the direct effect of B. The absence of viable organisms in affected lymph nodes in the presence of positive PCR for B. Corticosteroids have been anecdotally reported to have been administered to patients with CSD, apparently with some success. The purpose of this study is to evaluate the efficacy of corticosteroids in addition to azithromycin in CSD.
The study hypothesis is that corticosteroids will improve out come. Patients will be under followed up for 3 months. Major outcome measures will include duration of symptoms and signs, with particular emphasis on affected lymph node size and duration using a specific scoring system lymphadenitis score, LS. LS will be used to evaluate lymphadenitis at each follow-up visit. The historical control group will be consisted of age, sex, and clinical manifestations-matched CSD patients who were treated with azithromycin without corticosteroids.
Drug Information available for: Azithromycin Azithromycin dihydrate Azithromycin monohydrate. FDA Resources. Arms and Interventions.
Intervention Details: Drug: prednison and azithromycin Patients with typical cat-scratch disease will be treated with a 5-day course of prednison and azithromycin. Outcome Measures. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision.
Ability and willingness to comply with the protocol. Male and female patients aged years at the time of signing informed consent. Patients with clinical manifestations consistent with early typical cat scratch disease lymphadenitis before spontaneous improvement has been recorded and before development of suppuration. Known history of allergy, hypersensitivity, or any serious reaction to azithromycin, other macrolides or corticosteroids. Patients for whom azithromycin or corticosteroids is contra-indicated.
Current treatment with systemic corticosteroids. Patients with typical late cat scratch disease who has demonstrated constant improvement in the clinical manifestations of the involved lymph node.
Atypical cat scratch disease e. Endocarditis due to Bartonella sp. Diabetes mellitus. Peptic ulcer disease or history of upper GI bleeding. History of inadequately treated tuberculosis or evidence of tuberculosis in the chest radiography. Schizoaffective disorder, anxiety or depression treated with antipsychiatric drugs, at present or in the past. Treatment with any investigational drug in any clinical trial within 30 days prior to administration of study medication.
Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials. More Information. National Library of Medicine U. National Institutes of Health U.
Department of Health and Human Services. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Cat-scratch Disease Bartonella Infections. Drug: prednison and azithromycin Drug: prednison, azithromycin Drug: prednison, Azenil. Phase 4. Study Type :. Interventional Clinical Trial. Estimated Enrollment :. Study Start Date :.
Estimated Primary Completion Date :. November 10, Key Record Dates.
Azithromycin Dose Pack has an average rating of out of 10 from a total of 65 ratings on localhost 48% of reviewers reported a positive effect, while 36%. The study hypothesis is that corticosteroids will improve out come. Ten patients with typical CSD will be treated with a 5-day oral course of prednisone (1 mg/. Dear Dr. Roach: In late spring of , I had a sinus infection and was prescribed both an antibiotic and prednisone. between prednisone and Z-Pak. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider. Find patient medical information for Zithromax Z-Pak oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user. You can also connect with Dr. It works by killing bacteria or preventing their growth. If your dose is different, do not change it unless your doctor tells you to do so. Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, including fast, pounding, or irregular heartbeats. Dear E. Azithromycin may cause diarrhea, and in some cases it can be severe. This is a decision you and your doctor will make.Dear Dr. Roach: In late spring of , I had a sinus infection and was prescribed both an antibiotic and prednisone. I was told that the steroid would increase the effectiveness of the antibiotic.
After reading the patient insert for prednisone, I elected to take only the antibiotic, with excellent results. Since that time, three of my friends also were prescribed antibiotics by three different doctors for various conditions; all were also prescribed prednisone to take with it. Two of them did take the prednisone, resulting in really unpleasant side effects.
This week I went to another doctor, was diagnosed with acute nasopharyngitis and was told to take an antibiotic and prednisone. When I said I didn't want to take the prednisone, the doctor informed me that he never prescribes antibiotics without prednisone. I was prescribed clindamycin and methylprednisolone. I again elected not to take the steroid. Can you tell me if this dual prescribing is a widespread medical trend or just a local one?
Is there really a good reason for prescribing antibiotics and prednisone together, and am I being foolish not to follow doctor's orders? Dear E. These studies have shown a speedier recovery in those taking the combination of steroids and antibiotics than in those who take antibiotics alone, and I suspect that is why your doctors, and those of your friends, have been prescribing them.
However, there is a downside to steroids, as you note. It's not just the unpleasant immediate side effects, such as jitteriness and difficulty sleeping; steroids can have serious side effects in the short term confusion and even psychosis are well known.
In the long term, the list of possible side effects is very long, so the benefit must always be weighed against the possible harm. This is particularly the case in people at high risk for side effects, such as diabetics in whom sugar levels routinely go up when taking steroids or those with high blood pressure which often is exacerbated by steroid use.
Personally, I prefer to use nasal steroids in combination with antibiotics. They have many of the benefits of oral steroids with few of the side effects. Nasal steroids don't work as quickly as oral steroids, however. In any case, I can't condone you not following your doctor's recommendations. I certainly do recommend that you have a discussion about the benefits versus the harms, and I'd also recommend that you ask about nasal steroids.
Roach: I have read that atrial fibrillation gives you a greater chance of getting dementia. Do you agree? Dear K. However, it's not clear if the atrial fibrillation causes dementia or whether it is because some of the risks for developing dementia are also risks for developing atrial fibrillation. What is clear is that people who are not treated well for atrial fibrillation specifically, those people whose anticoagulation dosage is frequently too much or too little have a greater risk for dementia than those whose atrial fibrillation is well-controlled.
This is yet another reason that both patients and doctors should take particular care with anticoagulation. It isn't clear whether the newer anticoagulant drugs will have less risk of dementia.
View Comments View Comments. It isn't clear whether the newer anticoagulant drugs will have less risk of dementia — Readers may email questions to ToYourGoodHealth med.
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