Can You Take Steroids and Antibiotics Together?

If you have rheumatoid arthritis (RA), chances are you’re on—or have been on—some kind of steroid. In low doses, steroids can help ease joint pain from your RA. It’s also common for doctors to prescribe a short-term course of a steroid, like prednisone, to help you get through a particularly tough RA flare-up.
When taking a steroid, though, you need to be cautious about combining it with other medications, like antibiotics. Many people wonder: Is it okay to take antibiotics with steroids? Can the steroid enhance the antibiotic? We asked top medical experts to set the record straight about taking steroids and antibiotics together.

Difference Between Steroids and Antibiotics
Steroids (also known as corticosteroids) are medications that decrease inflammation in the body. Doctors often prescribe them to treat joint inflammation and swelling, like that which results from RA. Steroids are also used to treat allergic reactions, help with breathing conditions such as asthma, and calm an overactive immune system in people with autoimmune diseases such as lupus and RA, where the immune system mistakenly attacks healthy tissue. Some common types of oral corticosteroids are prednisone, methylprednisolone, dexamethasone, and cortisone.

Antibiotics work a bit differently. Antibiotics have an antibacterial effect—they target bacteria when you have an infection. So, for example, you might take an antibiotic to fight an infection such as strep throat, an ear infection, or a sinus infection. But because it kills bacteria, an antibiotic doesn’t help fight viruses such as the common cold, the flu, or COVID-19.

There are many different classes and types of antibiotics; talk with your doctor about the right one for you.

Can You Take Steroids and Antibiotics at the Same Time?
The answer to this question depends on the specific steroid, antibiotic, and the infection—but yes, in some cases, your physician may prescribe both drugs at the same time. The antibiotic targets bacteria and the steroid controls inflammation and resulting pain. For example, the steroid dexamethasone has proven effective in adults with bacterial meningitis, according to a study . The two are also often prescribed together for certain infections.

Drug Interactions Between Steroids and Antibiotics
Still, there are some potential interactions you should be aware of when taking both oral steroids and antibiotics. Here are common ones to be mindful of. Always talk with your provider if you are unsure about drug interactions or have follow-up questions.

Dexamethasone and Antibiotics
There is a potential interaction between dexamethasone, a type of steroid, and certain antibiotics. Dexamethasone and the antibiotic levofloxacin [part of the quinolone class of drugs] should not be used together because of increased risk for tendon rupture. The antibiotic erythromycin can raise the amount of dexamethasone in your system, increasing your risk of side effects.

Prednisone and Antibiotics
All corticosteroids, including prednisone, carry the risk of interacting with quinolone antibiotics (levofloxacin, ciprofloxacin) and causing a tendon (tissue that connects muscle to bone) to rupture. Mixing prednisone and penicillin antibiotics such as amoxicillin is considered safe, says expert.

Can You Drink Alcohol While on Antibiotics or Steroids?
There’s a reason doctors tell patients not to drink while taking medication, and it’s not because a glass of wine or a beer will make the antibiotics less effective. Alcohol can increase your risk of side effects while on certain medications. You should avoid alcohol while taking certain antibiotics. The combo can result in nausea, vomiting, rapid heart rate, and headaches.

There are no known interactions between alcohol and steroids such as prednisone but drinking large amounts of alcohol may increase your side effects, including an upset stomach. You could experience heartburn, acid reflux, or gas. To be safe, avoid drinking while taking oral steroids or at the very least, limit your intake.

Side Effects of Steroids and Antibiotics
Every drug carries a risk of side effects, and steroids and antibiotics are no different. But in the case of these two drugs, the gastrointestinal side effects can be worse when combined. Most side effects are related to GI toxicity. For example, common side effects of antibiotics are nausea, diarrhea, and upset stomach. Corticosteroids can also cause an upset stomach and cramping, as they irritate the stomach lining. So in short, combining antibiotics and steroids may increase the risk of stomach issues.

Why Doctors Prescribe Steroids With Antibiotics
When you’re sick, your doctor may prescribe both an oral steroid and an antibiotic. This is meant to speed up your healing. The steroid lessens the swelling and inflammation from an infection—for example, swelling in the sinus area in the case of a sinus infection—so the healing will be faster.

Do Steroids Increase Antibiotic Effectiveness?
Some research has suggested that the two medications work better together than either one alone in treating certain infections. For example, a recent review found that corticosteroids and antibiotics were more effective together in treating bacterial meningitis. Research on mice has also shown that taking steroids and antibiotics together improved recovery time for those with pneumonia. To be clear: Researchers don’t believe steroids make the antibiotics more effective, but by reducing the inflammation, the infection can resolve faster.

To sum up, it’s safe to take most antibiotics with steroids—and the combination may even help you recover from infection faster.

Post time: Aug-05-2022