As antibiotic resistance soars amid worrying news about the rise of a fatal condition, experts offer their tips on using the drugs. Photo / 123rf
As antibiotic resistance soars amid worrying news about the rise of a fatal condition, experts offer their tips on using the drugs. Photo / 123rf
We know the golden rule of antibiotics: don’t take them unnecessarily, and it’s really important to finish the course because of the risk of creating microbes that are resistant to future treatment.
This advice becomes ever more urgent with the news in November that a single course of antibiotics can raise the risk of the serious condition sepsis by 70 per cent.
According to scientists from the University of Manchester, people who had taken a single one or two-week course of antibiotics within the past 12 months were 70 per cent more likely to develop sepsis than those who did not.
The researchers behind the study said the exposure to antibiotics and “adverse effects on the beneficial bacteria in the gut could lead to increased susceptibility to infection”.
Sepsis — sometimes called septicaemia or blood poisoning — is the body’s extreme response to an infection, and a life-threatening medical emergency. There are 250,000 cases a year in Britain, and about 50,000 people die of it a year.
The infection is notoriously hard to spot, but symptoms can include fast, shallow breathing, shivering and vomiting, says the NHS. Sepsis is particularly dangerous in children.
People who have taken a single one or two-week course of antibiotics within the past 12 months were 70 per cent more likely to develop sepsis than those who did not.
All of which understandably raise concerns about the safe use of antibiotics. Clearly, if a doctor is strongly indicating you should take antibiotics for a serious bacterial infection, you should follow their instructions. But are there ways to mitigate the safety of the use of these common drugs?
Patients suffering common respiratory infections often pressure their GP to prescribe antibiotics for a viral infection. But research conducted in 2018 found 20 per cent of antibiotic prescriptions are unnecessary.
Doctors are always trying to balance “curing an infection and minimising the risk of antibiotic resistance”, says Professor Willem van Schaik, of the Institute of Microbiology and Infection. “If their use is necessary, then that is a good use; we wouldn’t want to say nobody [can use] antibiotics — but reducing their unnecessary use is a very good step.”
It can be difficult to identify whether an infection is bacterial or viral because some of the symptoms can be similar, but most cases of a cough, cold, the flu or a sore throat are viral and won’t respond to antibiotics. But how can you tell which is which?
As a patient, the best course of action is to flag concerning symptoms to your GP. “It’s an overgeneralisation, but generally viruses have a higher fever than bacteria,” says Dr Jeremy Harris from the Private GP Group.
A probiotic is traditionally defined as a bacteria that, when ingested, has a positive health benefit. Photo / Getty Images
Do: Take a probiotic or eat fermented foods along with your prescription
A course of antibiotics can have a negative impact on the gut: as well as killing bad bacteria, they can wipe out the “good” bacteria that make up the gut microbiome.
“When you take an antibiotic, you do so because it’s going to hit a particular microbe — if you have a chest infection, you want it to hit the microbe in your lung,” explains Ted Dinan, a professor of psychiatry at University College Cork and co-author of The Psychobiotic Revolution. “The problem with antibiotics is they have ‘off-target’ effects … A broad-spectrum antibiotic is likely to knock out a lot of bacteria in your gut.” It takes about 12 weeks for the gut microbiome to return to normal or nearly normal after a course of antibiotics.
Many suggest taking a probiotic to counter this effect. “A probiotic is traditionally defined as a bacteria that, when we ingest it, it has a positive health benefit.
“I don’t think the evidence is conclusive that taking a probiotic is particularly useful when you’re taking antibiotics,” says Dinan. “But I think there is enough evidence to suggest it is sensible. I would argue that the best matrix for ingesting probiotics is [through] foods, not capsules.”
Don’t: Take an old course of antibiotics for a later illness
For the same reason, van Schaik strongly advises against sharing or storing antibiotics. “You should only take a course of antibiotics when it has been prescribed to you,” he says. “You should never go back and self-medicate.”
Harris agrees you mustn’t do so “off your own back” because the drugs might not be the right antibiotics for a new condition — always seek medical advice.
Vaccination is “very important” in the fight against antibiotic resistance, says Professor Willem van Schaik, of the Institute of Microbiology and Infection. Photo / Warren Buckland
Do: Stay up to date with vaccines
The key difference between bacteria and viruses is that bacteria are cells that can survive on their own and can be treated with antibiotics, and viruses cause infection by multiplying within a healthy host cell.
Vaccination is “very important” in the fight against antibiotic resistance, says van Schaik. “There are multiple bacterial infections we are vaccinated against, including meningitis, for example, and by taking these vaccines you protect yourself against life-threatening disease.”
Don’t: Stop your course of pills halfway through
While research continues into the optimal number of days to take antibiotics for certain infections, the advice to always take them as prescribed still applies, according to van Schaik. Stopping halfway through a prescribed course can encourage antibiotic resistance.
Do: Limit your alcohol use
According to NHS guidance, moderate alcohol consumption is unlikely to cause problems when taking common antibiotics. “However, there are certain antibiotics that will make you sick if you drink with them,” says Harris. “As a general rule, everyone taking antibiotics should limit their alcohol intake. When you’re not well, the alcohol and the antibiotic will compete for how they’re metabolised, so you might get a worse response to the antibiotic,” he says. “It’s not that you can’t drink, it’s that you won’t get better quickly if you do drink.”
