Antibiotic-Corticosteroid combination

[Pharmacie]

In some preparations there is a combination of a coticosteroid and an antibiotic.
Although corticosteriods are powerful anti-inflammatory but by inhibition of IL-2corticosteriods weaken the immunity giving the bacteria a chance to resist the antibiotic.

1-what is the benefit of the combination?

2-Is it better to use an antibiotic alone ?

3-In which cases the combination is used ?

4-In which cases an antibiotic alone is prefered ?

[DavidS]

What kind of answer, what level of information, are you expecting?

Are these preparations available freely in Saudi-Arabia?

[Fleegle]

Given the urgency of your request, I responded immediately. My local GPs are all currently attending the annual 'cheese and bridge' evening in the pub, and are therefore unavailable until Thursday. My dentist however did pick up the phone, and had this to say..

' Ah right!...well as far as I know, and I'm no expert, progressive external inflammatory root resorption, a result of persistent inflammation within the periodontal membrane, will cause eventual destruction of the tooth root if the inflammation is not eradicated. I know of a study which examined the effects of an antibiotic/corticosteroid paste on experimental inflammatory resorption induced in monkeys in vivo. Histologic evaluation of results with the use of a morphometric technique revealed that the paste eliminated inflammatory root resorption and had no damaging effects upon the periodontal membrane. It was concluded that this antibiotic/corticosteroid combination is an effective medication for use in the treatment of progressive root resorption in traumatically injured teeth....thought you would have known that yourself Fleeg'

Hope this helps.

[Pharmacie]

I asked this question because during the clerkship in community pharmacy I have seen an ophthalmic ointment contains dexamethasone & polymixin B.For me It was strange to combine an antibiotic with a corticosteriod.

I asked the pharmacist about such combinations he said the corticosteriod component is to reduce the inflammation while the antibiotic component is to kill the bacteria.
An antibiotic alone can be used but in this case there is no fast releif of the inflammation symptoms ( swelling , itching , redness ).

But I don't know if the effectiveness of an antibiotic is effected by the addition of a corticosteriod?



Thank you Fleegle for answer but I have a small comment.

The study your dentist mentioned didn't compare Corticosteriod-antibiotic combination and antibiotic alone.
In case of trauma why don't we use an anti-inflammatory alone unless a bacterial infection exists.



Thanks .

[crit care]

for something topical i wouldn't have thought the concentrations would be significant enough to allow the bacteria to become resistant to the antibiotic.

[DavidS]

The study your dentist mentioned didn't compare Corticosteriod-antibiotic combination and antibiotic alone.

rofl

[Pharmacie]

I 've seen the lable of Tobradex® ( in FDA website ) which is an ophthalmic suspension contains Dexamethasone & Tobramycin.

It was written

"CLINICAL PHARMACOLOGY: Corticoids suppress the inflammatory response to a variety of agents and they probably delay or slow healing. Since corticoids may inhibit the body's defense mechanism against infection, a concomitant antimicrobial drug may be used when this inhibition is considered to be clinically significant".
This combination is contraindicated in case of viral or fungal infection .

Thanks.

[johnep]

Oh Pharmacie! Cannot make up my mind whether you are a spammer or not.

'This combination is contraindicated in case of viral or fungal infection '.

That rules out a host of popular products then, such as Fucidin H, Canestan H, Genticin drops etc etc.

Any one actually in pharmacy would know that combinations of antibacterial/antifungal are used widely.

Antivirals, however, would be contraindicated. I think you are just trying us on with a few quotes from Wiki.

Prove you are genuine or the axe will fall! I love playing the Queen of Hearts.
johnep

[Pharmacie]

thank you jhonep for your answer.

here you can see the lable from The FDA website :

http://www.accessdata.fda.gov/drugsa...bradex_lbl.pdf

you can see that Tobradex is contraindicated in case of viral or fungal infections.

During the clerkship I don't think that I've seen antibactrial\antifungal combination as an ophthalmic preparation.


thanks .

[johnep]

OK, Tomorrow will post a list of such combinations. Must say, 90% of UK eye drop scripts are for chloramphenicol. Rest are mainly Fusidic acid. Caution would be observed in eyes because of viral risk.
The acknowledged experts would be Moorfields Hospital.
johnep