Antibiotics can be lifesavers…or life threatening.  What do you need to know to keep them working for you, and not against you?

Antibiotic Fact Number One

One fact is finally well-known. Antibiotics treat bacterial infections, not viral, and that message is getting through, says Ghinwa Dumyati, MD, professor of medicine, physician and infectious disease specialist at the University of Rochester Medical Center’s Center for Community Health and Prevention. She said that fewer people ask her, automatically: “Doc, how about an antibiotic?”

Antibiotic Fact Number Two

Shorter Courses Are Better: “In the past, we used to treat infections for a long period of time,” Dumyati says. For instance, in years past, antibiotics were given for pneumonia for about 2 weeks; now the typical course is 5 days. Likewise, she adds, cellulitis typically warrants 5 days of antibiotics. “There’s a big shift in duration.”

Of course, one big reason is to reduce the issue of antimicrobial resistance, which the World Health Organization sees as a top public health threat. (Antimicrobial resistance includes antibiotics, anti-virals, antifungals and anti parasitics.) “Antibiotic use affects the entire population,” Dumyati points out. How many antibiotics are used in a community affects the amount of resistant bacteria in the community, she says.

During COVID, antibiotics were widely misused, the World Health Organization reported. While just 8% of hospitalized patients had a bacterial co-infection warranting antibiotic use, some 75% were given antibiotics “just in case.”

And what about dental care? The list of people advised to take prophylactic antibiotics before dental procedures has gotten much shorter. The American Dental Association spells out the new recommendations here, including, for instance, a small number of patients who have infective endocarditis (heart inflammation).

Antibiotic Fact Number Three

Adverse Interactions with Food or other Drugs.  Antibiotics can interact badly both with other medicines and foods, and these hazards can vary according to the antibiotic type and the other medicines.

For instance, antibiotics can interact adversely with warfarin, beta blockers and non-steroidal anti-inflammatories (NSAIDs), among other medicines. Before getting any antibiotic, make sure your doctor prescribing the antibiotic knows what other medicines you take.

Most antibiotics don’t affect hormonal birth control (in case anyone is wondering if that’s how they got pregnant oh so many years ago),  but one known as rifampin could. However, it isn’t available in the U.S. now. Still, it’s wise for those taking that form of contraception to ask about any precautions.

Grapefruit juice, as well as dietary supplements such as calcium, could affect how well your antibiotic works, and taking them with fruit juice or dairy products isn’t advised, either.

Coffee hounds can rejoice (maybe). Research is mixed, but in a 2022 study, researchers found coffee boosted the effects of certain antibiotics, including gentamycin, cefepime, azithromycin and novobiocin.

Adverse Effects: Antibiotic adverse effects can run the gamut, from a pesky rash that’s transient to one so severe it lands you in the ER. Gastrointestinal ills are common, with one of the most serious C. diff, or Clostridioides difficile, a bacterium that can cause life-threatening damage to the colon.  It can start 5-10 days after beginning an antibiotic.

Other antibiotics can be ototoxic, leading to tinnitus, or ringing in the ears, as well as other hearing or balance issues, but that’s not common, Dumyati says. However, it can happen; one of the likely drugs that may cause it are antibiotics  such as azithromycin, gentamicin, tobramycin and others. If you have hearing issues to begin with, check with your doctor and ask if there is an alternative.

YOUR TURN

What are your best tips about taking antibiotics? Share your experience and advice in the comments!

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, MedCentral and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.
Doheny photo: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.