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Prednisone (Oral Route) Precautions - Mayo Clinic |
Prednisone and antibiotics
Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels lack of certain substances that are usually produced by the body and are needed for normal body functioning. Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis a disease in which the nerves do not function properly ; lupus a disease in which the body attacks many of its own organs ; and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines.
Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
Prednisone comes as a tablet, delayed-release tablet, as a solution liquidand as a concentrated solution to take by mouth. Prednisone is usually taken with food one to four times a day or once every other day. Your doctor will probably tell you to take your dose s of prednisone at certain time s of day every day. Your personal dosing schedule will depend on your condition and on how you respond to treatment.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take prednisone exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor. If you are taking the concentrated solution, use the specially marked dropper that comes with the medication to measure your dose. You may mix the concentrated solution with juice, other flavored liquids, or soft foods such as applesauce.
Your doctor may change your dose of prednisone often during your treatment to be sure that you are always taking the lowest dose that works for you. Your doctor may also need to change your dose if you experience unusual stress on your body such as surgery, illness, infection, or a severe asthma attack.
Tell your doctor if your symptoms improve or get worse or if you get sick or have any changes in your health during your treatment. If you are taking prednisone to treat a long-lasting disease, the medication may help control your condition but will not cure it.
Continue to take prednisone even if you feel well. Do not stop taking prednisone without talking to your doctor. If you suddenly stop taking prednisone, your body may not have enough natural steroids to function normally. This may cause symptoms such as extreme tiredness, weakness, slowed movements, upset stomach, weight loss, changes in skin color, sores in the mouth, and craving for salt.
Call your doctor if you experience these or other unusual symptoms while you are taking decreasing doses of prednisone or after you stop taking the medication. Prednisone is also sometimes used with antibiotics to treat a certain type of pneumonia in patients with acquired immunodeficiency syndrome AIDS. Talk to your doctor about the risks of using this drug for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information. Your doctor may instruct you to follow a low-salt, high potassium, or high calcium diet.
Your doctor may also prescribe or recommend a calcium or potassium supplement. Follow these directions carefully. Talk to your doctor about eating grapefruit and drinking grapefruit juice while you are taking this medication.
When you start to take prednisone, ask your doctor what to do if you forget to take a dose. Write down these instructions so that you can refer to them later. Call your doctor or pharmacist if you miss a dose and do not know what to do. Do not take a double dose to make up for a missed dose. Prednisone may slow growth and development in children. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor about the risks of giving prednisone to your child.
Prednisone may increase the risk that you will develop osteoporosis. Talk to your doctor about the risks of taking prednisone and about things that you can do to decrease the chance that you will develop osteoporosis.
Some patients who took prednisone or similar medications developed a type of cancer called Kaposi's sarcoma.
Talk to your doctor about the risks of taking prednisone. Prednisone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. Keep this medication in the container it came in, tightly closed, and out of reach of children.
Store it at room temperature and away from excess heat and moisture not in the bathroom. It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet.
Instead, the best way to dispose of your medication is through a medicine take-back program. In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Keep all appointments with your doctor and the laboratory.
Your doctor will order certain lab tests to check your body's response to prednisone. If you are having any skin tests such as allergy tests or tuberculosis tests, tell the doctor or technician that you are taking prednisone. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Generic alternatives may be available.
Prednisone pronounced as pred' ni sone. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names. Swallow the delayed-release tablet whole; do not chew or crush it. Other uses for this medicine.
What special precautions should I follow? Before taking prednisone, tell your doctor and pharmacist if you are allergic to prednisone, any other medications, or any of the inactive ingredients in prednisone tablets or solutions. Ask your doctor or pharmacist for a list of the inactive ingredients. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. John's wort.
If you become pregnant while taking prednisone, call your doctor. You should carry a card or wear a bracelet with this information in case you are unable to speak in a medical emergency. Stay away from people who are sick and wash your hands often while you are taking this medication. Be sure to avoid people who have chicken pox or measles. Call your doctor immediately if you think you may have been around someone who had chicken pox or measles. Prednisone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: headache dizziness difficulty falling asleep or staying asleep inappropriate happiness extreme changes in mood changes in personality bulging eyes acne thin, fragile skin red or purple blotches or lines under the skin slowed healing of cuts and bruises increased hair growth changes in the way fat is spread around the body extreme tiredness weak muscles irregular or absent menstrual periods decreased sexual desire heartburn increased sweating Some side effects can be serious.
If you experience any of the following symptoms, call your doctor immediately: vision problems eye pain, redness, or tearing sore throat, fever, chills, cough, or other signs of infection seizures depression loss of contact with reality confusion muscle twitching or tightening shaking of the hands that you cannot control numbness, burning, or tingling in the face, arms, legs, feet, or hands upset stomach vomiting lightheadedness irregular heartbeat sudden weight gain shortness of breath, especially during the night dry, hacking cough swelling or pain in the stomach swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs difficulty breathing or swallowing rash hives itching Prednisone may slow growth and development in children.
What other information should I know? Browse Drugs and Medicines.
❿Prednisone and antibiotics.Can You Take Steroids and Antibiotics Together?
Your doctor will order certain lab tests to check your body's response to prednisone. If you are having any skin tests such as allergy tests or tuberculosis tests, tell the doctor or technician that you are taking prednisone. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Generic alternatives may be available. Prednisone pronounced as pred' ni sone. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow?
What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication?
Brand names. Swallow the delayed-release tablet whole; do not chew or crush it. Other uses for this medicine. What special precautions should I follow?
Before taking prednisone, tell your doctor and pharmacist if you are allergic to prednisone, any other medications, or any of the inactive ingredients in prednisone tablets or solutions.
Ask your doctor or pharmacist for a list of the inactive ingredients. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. John's wort. If you become pregnant while taking prednisone, call your doctor. You should carry a card or wear a bracelet with this information in case you are unable to speak in a medical emergency.
Stay away from people who are sick and wash your hands often while you are taking this medication. Be sure to avoid people who have chicken pox or measles. Call your doctor immediately if you think you may have been around someone who had chicken pox or measles. 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 in The New England Journal of Medicine. The two are also often prescribed together for certain infections.
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. There is a potential interaction between dexamethasone, a type of steroid, and certain antibiotics. The antibiotic erythromycin can raise the amount of dexamethasone in your system, increasing your risk of side effects.
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 Madison. Alcohol can increase your risk of side effects while on certain medications.
You should avoid alcohol while taking certain antibiotics such as Flagyl metronidazole , Tindamax tinidazole , and Bactrim sulfamethoxazole.
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.
To be safe, avoid drinking while taking oral steroids or at the very least, limit your intake. Previous data indicated that treatment with prednisone in combination with antibiotics results in significant acceleration of the healing phase. Objectives: To investigate the effectiveness of corticosteroids combined with antibiotics for the treatment of erysipelas.
Methods: A retrospective study was conducted on hospitalized patients diagnosed with erysipelas between and at the Department of Dermatology at Sheba Medical Center, Israel.
❾-50%}Prednisone and antibiotics
Prednisone may increase the risk that you will develop osteoporosis. Talk to your doctor about the risks of taking prednisone and about things that you can do to decrease the chance that you will develop osteoporosis.
Some patients who took prednisone or similar medications developed a type of cancer called Kaposi's sarcoma. Talk to your doctor about the risks of taking prednisone. Prednisone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture not in the bathroom.
It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.
However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program.
In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to prednisone. If you are having any skin tests such as allergy tests or tuberculosis tests, tell the doctor or technician that you are taking prednisone.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital.
It is also important information to carry with you in case of emergencies. Generic alternatives may be available. Prednisone pronounced as pred' ni sone. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow? What special dietary instructions should I follow? What should I do if I forget a dose? What side effects can this medication cause? What should I know about storage and disposal of this medication?
Brand names. Swallow the delayed-release tablet whole; do not chew or crush it. Other uses for this medicine. What special precautions should I follow? Before taking prednisone, tell your doctor and pharmacist if you are allergic to prednisone, any other medications, or any of the inactive ingredients in prednisone tablets or solutions. Ask your doctor or pharmacist for a list of the inactive ingredients. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
John's wort. If you become pregnant while taking prednisone, call your doctor. You should carry a card or wear a bracelet with this information in case you are unable to speak in a medical emergency. Stay away from people who are sick and wash your hands often while you are taking this medication. Be sure to avoid people who have chicken pox or measles. You may need to slowly decrease your dose before stopping it completely.
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any unwanted effects that may be caused by this medicine. Blood or urine tests may be needed to check for unwanted effects.
Using this medicine while you are pregnant can harm your unborn baby. Use an effective form of birth control to keep from getting pregnant. If you think you have become pregnant while using this medicine, tell your doctor right away. If you are using this medicine for a long time, tell your doctor about any extra stress or anxiety in your life, including other health concerns and emotional stress. Your dose of this medicine might need to be changed for a short time while you have extra stress.
Using too much of this medicine or using it for a long time may increase your risk of having adrenal gland problems. Talk to your doctor right away if you have more than one of these symptoms while you are using this medicine: blurred vision, dizziness or fainting, a fast, irregular, or pounding heartbeat, increased thirst or urination, irritability, or unusual tiredness or weakness. This medicine may cause you to get more infections than usual. Avoid people who are sick or have infections and wash your hands often.
If you are exposed to chickenpox or measles, tell your doctor right away. If you start to have a fever, chills, sore throat, or any other sign of an infection, call your doctor right away. Check with your doctor right away if blurred vision, difficulty in reading, eye pain, or any other change in vision occurs during or after treatment.
Your doctor may want you to have your eyes checked by an ophthalmologist eye doctor. While you are being treated with prednisone, do not have any immunizations vaccines without your doctor's approval. Prednisone may lower your body's resistance and the vaccine may not work as well or you might get the infection the vaccine is meant to prevent.
In addition, you should not be around other persons living in your household who receive live virus vaccines because there is a chance they could pass the virus on to you. Some examples of live vaccines include measles, mumps, influenza nasal flu vaccine , poliovirus oral form , rotavirus, and rubella. Do not get close to them and do not stay in the same room with them for very long.
If you have questions about this, talk to your doctor. This medicine may cause changes in mood or behavior for some patients. Tell your doctor right away if you have depression, mood swings, a false or unusual sense of well-being, trouble with sleeping, or personality changes while taking this medicine. This medicine might cause thinning of the bones osteoporosis or slow growth in children if used for a long time.
Tell your doctor if you have any bone pain or if you have an increased risk for osteoporosis. If your child is using this medicine, tell the doctor if you think your child is not growing properly. Make sure any doctor or dentist who treats you knows that you are using this medicine.
This medicine may affect the results of certain skin tests. Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription over-the-counter [OTC] medicines and herbal or vitamin supplements.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:.
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Background: Erysipelas, an acute infection of the dermal and subcutaneous tissue, is normally treated with antibiotics. Previous data indicated that treatment with prednisone in combination with antibiotics results in significant acceleration of the healing phase.
Objectives: To investigate the effectiveness of corticosteroids combined with antibiotics for the treatment of erysipelas. Methods: A retrospective study was conducted on hospitalized patients diagnosed with erysipelas between and at the Department of Dermatology at Sheba Medical Center, Israel. Data included epidemiology, medical background, and course of the disease as documented at admission and during hospitalization.
The study group presented with a more severe form of erysipelas bullous and those patients were hospitalized for a longer period 8. Short-term follow-up revealed more edema in the study group; however, long-term follow-up revealed a higher incidence of erythema and recurrence of erysipelas in the control group. The return to full function was faster in the study group than in the control group. Conclusions: Combining prednisone with antibiotics for the treatment of erysipelas should be considered, especially in severe cases.
In addition, a prospective double-blind study should be conducted to verify these conclusions. Abstract Background: Erysipelas, an acute infection of the dermal and subcutaneous tissue, is normally treated with antibiotics.
Conclusions: Combining prednisone with antibiotics for the treatment of erysipelas should be considered, especially in severe cases. In addition, a prospective. These studies have shown a speedier recovery in those taking the combination of steroids and antibiotics than in those who take antibiotics. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing. Otic antibiotic/corticosteroid combinations are used to treat inflammation and bacterial infection in the ears. Antibiotics kill bacteria. Corticosteroids/Selected Macrolide Antibiotics Interactions. This information is generalized and not intended as specific medical advice. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Other uses for this medicine. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.Jump to navigation. Chronic suppurative otitis media CSOM is an inflammation and infection of the middle ear that lasts for two weeks or more. People with CSOM usually experience recurrent or persistent ear discharge — pus that leaks out from a hole in the eardrum — and hearing loss. CSOM is commonly treated with a combination of antibiotics medicines that fight bacterial infections and steroids anti-inflammation medicines as a topical treatment that is, in the form of drops, sprays, ointments or creams put directly into the ear.
To find out how effective this combination is, and whether it causes unwanted effects, we reviewed the evidence from research studies. We searched for all relevant studies in the medical literature, compared the results and summarised the evidence from all the studies. We also assessed how certain the evidence was, considering factors such as study size and the way studies were conducted.
Based on our assessments, we categorised the evidence as being of very low, low, moderate or high certainty. We found 17 studies on over people with CSOM.
People were followed for between 10 days and 20 weeks after treatment was completed. The studies covered a range of antibiotic plus steroid combinations, and compared them with either no treatment, a fake treatment placebo , the same antibiotic without steroids or different antibiotics without steroids. Here we report findings from the three main comparisons:. Topical antibiotics plus steroids compared against placebo fake treatment or no treatment three studies, people. We do not know whether antibiotics plus steroids are better or worse than placebo or no treatment for:.
This is because either no studies considered these outcomes or the evidence was of very low certainty. Topical antibiotics plus steroids compared against the same topical antibiotic used alone four studies, people. Topical antibiotics plus steroids may make little or no difference to stopping ear discharge after one to two weeks low-certainty evidence.
We do not know whether antibiotics plus steroids are better or worse than the same topical antibiotic used alone for:. Topical antibiotics other than quinolones a family of antibiotics plus steroids compared to topical quinolone antibiotics used alone nine studies, at least people plus an additional 40 ears. Non-quinolone antibiotics plus steroids may not be as effective as quinolone antibiotics used alone at stopping ear discharge after one to two weeks low-certainty evidence. Steroids combined with non-quinolone antibiotics may not be as good as quinolone antibiotics alone to stop ear discharge after one to two weeks low-certainty evidence.
We are uncertain about the effectiveness of topical antibiotics with steroids in improving the resolution of ear discharge in patients with CSOM because of the limited amount of low-certainty evidence available.
Amongst this uncertainty, we found no evidence that the addition of steroids to topical antibiotics affects the resolution of ear discharge. There is also uncertainty about the relative effectiveness of different types of antibiotics; it is not possible to determine with any certainty whether or not quinolones are better or worse than aminoglycosides.
These two groups of compounds have different adverse effect profiles, but there is insufficient evidence from the included studies to make any comment about these. In general, adverse effects were poorly reported. Chronic suppurative otitis media CSOM is a chronic inflammation and often polymicrobial infection of the middle ear and mastoid cavity, characterised by ear discharge otorrhoea through a perforated tympanic membrane.
The predominant symptoms of CSOM are ear discharge and hearing loss. Topical antibiotics act to kill or inhibit the growth of micro-organisms that may be responsible for the infection.
Antibiotics can be used alone or in addition to other treatments for CSOM, such as steroids, antiseptics or ear cleaning aural toileting. Antibiotics are commonly prescribed in combined preparations with steroids. To assess the effects of adding a topical steroid to topical antibiotics in the treatment of people with chronic suppurative otitis media CSOM.
The date of the search was 16 March We included randomised controlled trials RCTs with at least a one-week follow-up involving participants adults and children who had chronic ear discharge of unknown cause or CSOM, where the ear discharge had continued for more than two weeks. The interventions were any combination of a topical antibiotic agent s of any class and a topical corticosteroid steroid of any class, applied directly into the ear canal as ear drops, powders or irrigations, or as part of an aural toileting procedure.
The two main comparisons were topical antibiotic and steroid compared to a placebo or no intervention and b another topical antibiotic. We used the standard Cochrane methodological procedures.
Our primary outcomes were: resolution of ear discharge or 'dry ear' whether otoscopically confirmed or not , measured at between one week and up to two weeks, two weeks to up to four weeks and after four weeks; health-related quality of life; ear pain otalgia or discomfort or local irritation.
Secondary outcomes included hearing, serious complications and ototoxicity. We included 17 studies addressing 11 treatment comparisons. A total of participants were included, with one study 40 ears not reporting the number of participants recruited, which we therefore could not account for.
No studies reported health-related quality of life. The main comparisons were:. Topical antibiotics with steroids versus placebo or no treatment. Three studies participants compared a topical antibiotic-steroid to saline or no treatment. Resolution of discharge was not reported at between one to two weeks.
One study 50 'high-risk' children reported results at more than four weeks by ear and we could not adjust the results to by person. One study participants reported no change in bone-conduction hearing thresholds and reported no difference in tinnitus or balance problems between groups very low-certainty evidence.
One study 50 participants reported serious complications, but it was not clear which group these patients were from, or whether the complications occurred pre- or post-treatment. One study participants reported that no side effects occurred in any participants very low-certainty evidence. Topical antibiotics with steroids versus topical antibiotics same antibiotics only.
Four studies participants were included in this comparison. Three studies participants compared topical antibiotic-steroid combinations to topical antibiotics alone. The evidence suggests little or no difference in resolution of discharge at one to two weeks: No results for resolution of discharge after four weeks were reported. One study participants reported local itchiness but as there was only one episode in each group it is uncertain whether there is a difference very low-certainty evidence.
Three studies participants investigated suspected ototoxicity but it was not possible to determine whether there were differences between the groups for this outcome very low-certainty evidence. No study reported serious complications.
Topical antibiotics with steroids compared to topical antibiotics alone different antibiotics. Nine studies participants plus 40 ears evaluated a range of comparisons of topical non-quinolone antibiotic-steroid combinations versus topical quinolone antibiotics alone. Resolution of discharge may be greater with quinolone topical antibiotics alone at between one to two weeks compared with non-quinolone topical antibiotics with steroids: Results for resolution of ear discharge after four weeks were not reported.
One study 52 participants reported usable data on ear pain, two studies participants reported hearing outcomes and one study 52 participants reported balance problems.
It was not possible to determine whether there were significant differences between the groups for these outcomes very low-certainty evidence. Two studies participants reported no serious complications very low-certainty evidence. Benefits and risks of combining antibiotics and steroids as drops, sprays, ointments or creams to treat chronic suppurative otitis media persistent or recurring ear infection with discharge Why this is important Chronic suppurative otitis media CSOM is an inflammation and infection of the middle ear that lasts for two weeks or more.
How we identified and assessed the evidence We searched for all relevant studies in the medical literature, compared the results and summarised the evidence from all the studies. Here we report findings from the three main comparisons: Topical antibiotics plus steroids compared against placebo fake treatment or no treatment three studies, people We do not know whether antibiotics plus steroids are better or worse than placebo or no treatment for: - stopping ear discharge at three time points one to two weeks; two to four weeks; or after four weeks ; or - hearing; or - causing unwanted effects such as ear pain or serious complications.
Topical antibiotics plus steroids compared against the same topical antibiotic used alone four studies, people Topical antibiotics plus steroids may make little or no difference to stopping ear discharge after one to two weeks low-certainty evidence. We do not know whether antibiotics plus steroids are better or worse than the same topical antibiotic used alone for: - stopping ear discharge at three time points one to two weeks; two to four weeks; or after four weeks ; or - hearing; or - causing unwanted effects such as ear pain or serious complications.
Topical antibiotics other than quinolones a family of antibiotics plus steroids compared to topical quinolone antibiotics used alone nine studies, at least people plus an additional 40 ears Non-quinolone antibiotics plus steroids may not be as effective as quinolone antibiotics used alone at stopping ear discharge after one to two weeks low-certainty evidence.
We do not know whether non-quinolone antibiotics plus steroids are better or worse for: - stopping ear discharge at three time points one to two weeks; two to four weeks; or after four weeks ; or - hearing; or - causing unwanted effects such as ear pain or serious complications. Across the different comparisons, no studies reported on health-related quality of life. What this means Steroids combined with non-quinolone antibiotics may not be as good as quinolone antibiotics alone to stop ear discharge after one to two weeks low-certainty evidence.
Too few robust studies have been conducted for us to know whether: - topical antibiotics plus steroids are better or worse than no treatment or a placebo; - adding steroids to a topical antibiotic affects the antibiotic's effectiveness or has an impact on unwanted effects.
How-up-to date is this review? The evidence in this Cochrane Review is current to March Authors' conclusions:. Search strategy:. Selection criteria:. Data collection and analysis:. Main results:. The main comparisons were: 1.
Topical antibiotics with steroids versus placebo or no treatment Three studies participants compared a topical antibiotic-steroid to saline or no treatment. Topical antibiotics with steroids versus topical antibiotics same antibiotics only Four studies participants were included in this comparison. Topical antibiotics with steroids compared to topical antibiotics alone different antibiotics Nine studies participants plus 40 ears evaluated a range of comparisons of topical non-quinolone antibiotic-steroid combinations versus topical quinolone antibiotics alone.
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