Taking Antibiotics Safely

Antibiotics are medications that treat bacterial infections. Penicillin was the first antibiotic widely available in the 1940s. Since then, researchers have developed several others.

These medicines come in capsules, chewable tablets, powders for liquid suspension, intravenous formulations, creams and ointments. Most are available only by prescription, though some topical creams and ointments may be available over-the-counter.

Antibiotics can treat bacterial infections of the ear, nose, throat, genitourinary tract and respiratory system. Each type of antibiotic may be more or less effective for certain strains of bacteria, so a medical provider will choose the antibiotic that will work best for the specific infection.

Antibiotics don’t work against infections caused by fungi such as yeast infections and athlete’s foot or viruses such as the flu and the common cold.

Using antibiotics incorrectly can lead to a relapse of illness or antibiotic resistance. Certain antibiotics can’t kill bacteria that have antibiotic resistance, and this can make it harder to treat serious infections.

Generally, antibiotics work to treat bacteria in two ways. Antibiotics called bactericidal agents cause bacterial cell death. Others called bacteriostatic agents stop bacteria growth and reproduction.

For example, bactericidal antibiotics like penicillin and amoxicillin cause breakdown in bacterial cell walls. This leads to cell death. Antibiotics like erythromycin and clarithromycin primarily prevent bacteria from synthesizing protein, stopping their growth.

Antibiotics start working right away after a person takes them. Each antibiotic may stay in the body for different lengths of time, but common antibiotics such as amoxicillin and ciprofloxacin stay in your system for about 24 hours after taking the last dose. It might take longer for people with impaired kidney function to eliminate the drug from the body.

Some antibiotics will take days to leave the body. Azithromycin stays in the body for about 15 days after the last dose.

Ask your pharmacist or medical provider for specific information on how long the antibiotic you are taking stays in the body.

There several classes of antibiotics available in the United States. These drugs are grouped together by their chemical structure. Each antibiotic class has similarities and differences in how effective they are at treating certain types of bacteria.

Always take antibiotics for the length of time that they are prescribed, even if symptoms have subsided. Make sure to read the drug label carefully before taking the medication and ask your medical provider or pharmacist about any side effects or precautions you should take.

It’s important to make sure you take your antibiotics at regularly scheduled doses — for example, every 8 hours or every 12 hours. This is so the medicine’s effect spreads out evenly over the course of a day. Make sure to ask your medical provider if you should take your medication with food or on an empty stomach.

If you miss a dose, take it as soon as you remember. But if it’s closer to your next scheduled dose, skip it and take your next dose at the regular scheduled time. Never take two doses at once to make up for a skipped dose.

Can you drink alcohol while taking antibiotics?

In general, it’s safe to drink alcohol in moderation with most antibiotics. But three antibiotics — metronidazole, tinidazole and trimethoprim-sulfamethoxazole — can lead to serious reactions with alcohol, according to the UK’s National Health Service and the University of Pittsburgh Medical Center.

The safety of drinking alcohol while taking specific antibiotics may be different for different people. Therefore, you should always check with your doctor or pharmacist before drinking alcohol while taking an antibiotic.

Can you eat dairy while taking antibiotics?

Eating dairy products such as butter, cheese, milk and yogurt can interfere with how some antibiotics work. You may have to wait up to three hours after taking an antibiotic to consume dairy products.

Do antibiotics affect birth control?

Some antibiotics may increase the breakdown of estrogen, decreasing the effectiveness of birth control. But according to Planned Parenthood, the only antibiotic that could make birth control less effective is rifampin, known under the brand names Rifadin and Rimactane.

In general, you should store antibiotics in a cool, dry place. But it’s important to follow instructions on the drug label and any instructions given by a medical provider or pharmacist regarding your specific antibiotic. For example, some medicines may need to be refrigerated.

Each package of medicine will have an expiration date printed on it. Don’t take antibiotics past the expiration date. Expired antibiotics may fail to properly treat infections and lead to antibiotic resistance, according to the FDA.

Tests on drug stability from the mid-1980s to early 1990s found that liquid antibiotics showed signs of physical decay after expiration, according to an article published by Harvard.

Antibiotics save lives, but nearly one out of five ER visits each year is linked to antibiotic side effects. These side effects are also the most common cause of ER visits for children younger than 18 years of age.

Because these are powerful drugs, people should be mindful of misusing them. Most common side effects are mild. If they get worse or don’t go away, talk to your medical provider.

Some side effects can be serious. These include allergic reactions and an infection caused by Clostridium difficile.

Allergic Reactions

Before you take antibiotics, tell your medical provider if you’ve had a history of allergic reactions to penicillin or other antibiotics.

Clostridium Difficile

Antibiotics alter the helpful bacteria in your gut and can lead to an overgrowth of a bacterium called Clostridium difficile, or C. diff, which can cause severe diarrhea and potentially fatal colitis (inflammation of the colon). Tell a medical provider if you develop severe diarrhea, fever, cramping, stomach pain or bloody stool after using antibiotics.

Taking Probiotics with Antibiotics May Help with Side Effects

In the case of diarrhea, abdominal cramping or gas, some research suggests taking a probiotic with your antibiotic may help lessen side effects, according to the Cleveland Clinic. Probiotics also include fermented foods like sauerkraut or yogurt.

Probiotics can also help with diarrhea from C. diff. In fact, one analysis published in the journal Infection Control and Hospital Epidemiology by Bradley Johnston and colleagues found a reduction of up to 65 percent in C difficile-associated diarrhea in patients taking probiotics with their antibiotics. This benefit may be greater in patients who have a higher risk of developing diarrhea from C. diff. Talk to your doctor to help determine if you are at a higher than usual risk.

The most commonly used probiotics for antibiotic-associated diarrhea are Lactobacillus rhamnosus-based and Saccharomyces boulardii-based probiotics. Before taking any probiotics, make sure you ask your medical provider or pharmacist if they are safe for you.

Antibiotic resistance occurs when bacteria develop ways to protect themselves against antibiotics.

“If you keep using the same antibiotics routinely, the bugs basically mutate, and they can live through antibiotic treatment,” immunologist and thoracic surgeon Dr. Hooman Noorchashm told Drugwatch.

This means fewer drugs can kill them, and these infections may become more dangerous. Someone who is infected with bacteria that is resistant to antibiotics will usually need to stay in the hospital longer and doctors will have to use treatments that are more expensive and have more side effects. Antibiotic-resistant bacteria cause more than 2.8 million infections annually, and more than 35,000 Americans die each year because of them, according to the Centers for Disease Control and Prevention.

Antibiotic resistance is one of the most urgent threats to public health. It is connected to the health of people, animals and the environment.

Antibiotic resistance can occur anytime antibiotics are used. That’s why it’s important not to use antibiotics if you don’t need them. If your doctor determines that you do not have an infection that needs antibiotics, you should not insist that you receive an antibiotic. Too many antibiotics are being misused and prescribed when they are not needed. The CDC estimates that about 47 million antibiotics are prescribed for infections, like the cold and flu, that do not need these drugs.

Another way you can help prevent the threat of antibiotic resistance is to make sure you take antibiotics as directed for the full length of treatment to kill all organisms. You should not save antibiotics for use at a later time and you should never share antibiotics with someone else.

Dr. Hooman Noorchashm prescribed antibiotics to his patients for years. These are some quick, basic tips that he gave his patients for taking antibiotics safely.