Do Antibiotics and Anti-Inflammatories Affect Stable Stiffness Conditions?

Q: Do Antibiotics and Anti-Inflammatories Affect Stable Stiffness Conditions?

Hello, thank you for your question. <br>Here are my responses： 1. <br>Will the aforementioned two medications cause stable stiffness to become unstable? --> I don't believe so. <br>2. <br>If they do induce instability, are there alternative medications? --> If pain recurs, it may

Subject: Do antibiotics and anti-inflammatory medications cause stable stiffness conditions to become unstable?

Dear Dr.
Gao,
I am a patient with ankylosing spondylitis, diagnosed three years ago.
My condition has been stable, so I have temporarily stopped taking Celecoxib for six months and Sulfasalazine for three months.
However, due to a wisdom tooth extraction, I developed an odontogenic cyst and underwent drainage surgery.
The doctor has prescribed the following two medications for one week:
1.
Amoxicillin/Clavulanate TAB 1000 mg (take one tablet every 12 hours)
2.
Acetaminophen TAB 500 mg (take one tablet three times a day after meals)
I would like to ask:
1.
Will these two medications cause my stable ankylosing spondylitis to become unstable?
2.
If they may induce instability, are there alternative medications available?
Thank you for your assistance, Dr.
Gao!

Xiao Zhong, 20~29 year old female. Ask Date: 2024/03/20

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Here are my responses: 1.
Will the aforementioned two medications cause stable stiffness to become unstable? --> I don't believe so.
2.
If they do induce instability, are there alternative medications? --> If pain recurs, it may be related to the disease itself and should not be attributed to these two medications.
For ankylosing spondylitis, tapering off medication is usually more successful after middle age.
I recommend that you consult a rheumatologist for a reassessment.
The Allergy, Immunology, and Rheumatology Department at Changhua Hospital, Ministry of Health and Welfare, is concerned about your health.

Reply Date: 2024/03/20

More Info

When considering the impact of antibiotics and anti-inflammatory medications on stable conditions such as ankylosing spondylitis (AS), it is essential to understand the nature of these medications and their potential effects on the disease.
1. Impact of Amoxicillin/Clavulanate and Acetaminophen on Ankylosing Spondylitis:
The antibiotics you have been prescribed, Amoxicillin/Clavulanate (commonly known as Augmentin), are used to treat bacterial infections. In your case, it is likely prescribed to prevent or treat any potential infections following your dental procedure. Generally, antibiotics do not directly affect the stability of ankylosing spondylitis. They target bacterial infections and do not influence the underlying inflammatory processes associated with AS.
Acetaminophen (known as paracetamol in many countries) is a pain reliever and fever reducer. It is not classified as an anti-inflammatory drug, although it can help alleviate pain. Since you have been stable for a significant period, taking these medications for a short duration (one week) should not destabilize your condition. However, it is crucial to monitor any changes in your symptoms, as individual responses can vary.

2. Alternatives if Concerns Arise:
If there are concerns about the medications affecting your condition, it is advisable to discuss alternatives with your healthcare provider. For instance, if you experience any adverse effects or if your symptoms worsen, your doctor may consider other pain management strategies or antibiotics that are less likely to interfere with your AS treatment.
In terms of alternatives, non-steroidal anti-inflammatory drugs (NSAIDs) are often used to manage pain and inflammation in ankylosing spondylitis. However, since you have been stable and have recently reduced your medication, it is essential to approach this cautiously. Always consult your rheumatologist or healthcare provider before making any changes to your medication regimen.

3. Monitoring and Follow-Up:
It is important to maintain regular follow-ups with your rheumatologist, especially when undergoing any surgical procedures or starting new medications. They can provide tailored advice based on your medical history and current condition. Regular monitoring of your symptoms and any side effects from new medications will help ensure that your ankylosing spondylitis remains stable.

In conclusion, the antibiotics and acetaminophen you are prescribed should not destabilize your ankylosing spondylitis, especially when taken for a short duration. However, it is always best to keep an open line of communication with your healthcare provider regarding any concerns or changes in your condition. Your health and well-being are paramount, and your medical team is there to support you through your treatment journey.

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