NSAIDs and COX-2 inhibitors: antibiotic therapy

Controling pain and inflammation:
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NSAIDs and COX-2 inhibitors are part of antibiotic therapy. The
only exception is for patients who have achieved a pain free
condition through the use of Minocin alone or in combination with
Zithromax.

The 1999 O’Dell study documents the reduction in the number of
tender and swollen joints of rheumatoid arthritis patients with a
positive rheumatoid factor who used Minocin, 100 mg, twice a day:

- 31.1 tender and swollen joints, on average, at the start of
study;
- 13.5 tender and swollen joints, on average, after 3 months;
- 5 tender and swollen joints, on average, after 9 months;
- 1 tender or swollen joint, on average, after 18 months.

For seronegative rheumatoid arthritis and seronegative
spondyloarthropathies, the progress should be even more dramatic
with patients being able to achieve a pain free or nearly pain
free condition with 10 to 13 weeks of Minocin.

Adequate anti-inflammatory medication must be maintained at all
times, throughout the therapy, until a pain free condition can be
achieved. Permanent joint damage and finger deformity can be
avoided only through adequate anti-inflammatory medication.
Bursitis, a painful bursitis, is evidence of inflammation.

To control pain and inflammation, patients should use COX-2
inhibitors like Celebrex (celecoxib), 200 mg, once or twice a
day, or good NSAIDs such as Voltaren (diclofenac) or Arthrotec
(diclofenac and misoprostol), Indocid (indomethacin) and Relafen
(nabumetone). The initial dosage of Voltaren, Arthrotec and
Indocid can be limited to 150 mg per day, whereas Relafen is
started at 1,500 mg per day. If the initial dosage does not
provide adequate relief from pain and inflammation, patients may
increase dosage as follows:

– Voltaren or Arthrotec, 75 mg, Slow Release, after breakfast and
supper, and Voltaren or Arthrotec, 50 mg, after lunch, for a
total daily dosage of 200 mg; or

– Indocid, 75 mg, Slow Release, after breakfast and supper, and
Indocid, 50 mg, after lunch, for a total daily dosage of 200 mg;
or

– Relafen, 1,000 mg, after breakfast and supper, for a total
daily dosage of 2,000 mg.

Ideally, NSAIDs and COX-2 inhibitors should be taken 30 minutes
after the start of a meal, at a moment when the stomach has
achieved maximum protection against stomach acid. In practice,
NSAIDs and COX-2 inhibitors are taken at the end of a meal.