Nothing to Fear: 10 Antibiotic Myths That Interfere with Treatment

Posted by Isabelle Marsh on December 21st, 2020

It is impossible to imagine modern medicine without antibiotics. Today such drugs are able to fight superbugs and treat uncomplicated appendicitis. The endless search is associated with the fact that the longer mankind uses antibiotics, the higher the likelihood of bacteria resistance to them - that is, the risk that new drugs will be required.

As statistics show, people know too little about antibiotics. For some reason, the population continues to believe in myths: many people are still convinced that antibiotics can cure influenza, although it is useless to treat viral infections with them. This is just one of the common misconceptions. We've put together ten common myths about antibiotics that should be dispelled.

1. Injections are better than pills

A couple of decades ago, injectable antibiotics were more commonly used in hospitals than oral antibiotics. This was quite justified since in the arsenal of doctors was small and their choice was rather limited. Bioavailability was then higher for injectable forms (about 80%; for tablets it was 40-60%).

Since then, a lot has changed in the world of antibiotics: they have become more perfect, "learned" to work faster, and the tablets were finally able to boast of bioavailability reaching 90–95%. Oral antibiotics are easier to use and significantly safer.

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2. Antibiotics should be taken with probiotics

Antibiotics destroy bacteria, and probiotics restore intestinal microflora - sounds logical. However, in fact, antibiotics in the overwhelming majority of cases do not cause either dysbiosis or thrush. Of course, there is a small risk, but usually, the only thing that a person faces with a course of antibiotics is short-term diarrhea.

Doctors are skeptical about probiotics: more research is needed to understand which strains of bacteria are most beneficial and in what doses. Experts at the Mayo Clinic believe that the best way to get your gut in order is to drink plenty of fluids and eat foods that are milder than your usual diet, and cut down on fiber.

3. Antibiotics should always be taken in a course

We've all heard that a course of antibiotics is a must - but researchers aren't sure if this is really necessary if you feel better. According to recent data, early cessation of antibiotic therapy does not contribute to the development of resistance, but taking antibiotics longer than necessary just increases this risk. In addition, for the sake of patient convenience, they are trying to create new drugs so that drugs are not taken for a long time - and there are even single-dose antibiotics.

However, there are some diseases (the most obvious example is tuberculosis), in which refusal from the drug in the middle of the course can lead to serious consequences. Experts say that the ideal length of treatment has not yet been determined - it varies from person to person and depends on which antibiotics the person has used in the past.

4. You always need to do a sensitivity test

Such tests really help to avoid many problems and choose an antibiotic that will work exactly as necessary. But in many cases, the medical algorithm includes a prescription of a broad-spectrum drug that affects different types of bacteria, including the most likely ones for this disease.

Only later, a doctor prescribes another antibiotic (if necessary) aimed at solving a narrower problem. At the same time, research results show that antibiotics of the first type can be at least as effective.

5. Antibiotics are evil for children and pregnant women

Researchers believe that antibiotics should be used with caution in pregnant women. This, however, does not mean that they are prohibited - it is only important to think about their expediency in each specific case. Antibiotics are not dangerous but only if they are taken as indicated and in the correct regimen.

Recently, the World Health Organization has updated the list of essential medicines, dividing antibiotics into recommended, controlled and reserve antibiotics - this is important precisely for the prescription of the "right" antibiotics in each case.

6. Antibiotics can be used to prevent diseases

Antibiotic prophylaxis is used to reduce the risk of infections associated with open fractures and wounds, and in such cases it is justified. But often antibiotic prophylaxis means preventing infections in everyday situations - for example, when a person goes on vacation to an unfamiliar country and wants everything to go smoothly.

We are talking primarily about an intestinal disorder known as traveler's diarrhea that occurs against the background of a change in the diet or climate zone. However, doctors around the world agree that such prevention is overkill. It is more correct and safer to be careful with food and water choices and, alternatively, ask your doctor to recommend an antibiotic in case a problem does arise.

7. Resistance occurs only due to the constant use of antibiotics

The widespread use of antibiotics has accelerated the rate at which bacteria are becoming resistant to them. But you must not think that only regular and uncontrolled use of antibiotics can lead to resistance. Scientists have found that antibiotic resistance genes may be to blame. They give bacteria the ability to destroy antibiotics of the carbapenem class - one of the main agents against extremely dangerous superbugs.

Not so long ago, it turned out that some bacteria destroy other microbes, "picking up" the remnants of their DNA, which may contain genes for antibiotic resistance, and this complicates the task. At the moment, a promising solution to the problem is a thorough study of plasmids - molecules that carry genetic information - and the development of agents that would prevent resistance genes from attaching to these plasmids.

8. Any antibiotic is better than nothing

Are there universal antibiotics that can help anyway? The answer is no. There are drugs with a wide spectrum of action, but even they are always prescribed based on which type of bacteria is most likely present in the patient.

Experts estimate that about 50% of antibiotics worldwide are purchased without a prescription. And this is not good: in addition to a general concern about the growing number of antibiotic-resistant bacteria, there is a risk of overshooting with a type of medicine, its dosage or compatibility with other drugs that require constant intake. In addition, the use of antibiotics to fight mild bacterial infections such as pharyngitis or bronchitis is most often not required, as our immune system is able to cope with it on its own.

9. Antibiotics in meat are a health threat

To begin with, antibiotics are not used uncontrollably as growth stimulants or to treat infections in animals - and there is ongoing research on this topic. And so far none of them has allowed us to reasonably talk about the dangers of such an application for people - another thing is that it is better to limit the amount of red meat in the diet for other reasons.

You should keep in mind that even animals in organic, natural or biodynamic farming are treated with antibiotics if needed. Although, WHO recently asked farmers not to do this unnecessarily.

10. Antibiotics are incompatible with alcohol

Most popular antibiotics are compatible with alcohol. In any case, one or two glasses of wine is not a reason to interrupt the course or think that antibiotics have ceased to work and you need to start taking them all over again. They say that combining alcohol with antibiotics was banned during the Second World War. Then the production of the drug was not massive and it was used many times - urine was collected from patients to get new penicillin. The beer that the soldiers drank increased the volume of urine, and it was more difficult to process it.

There are exceptions: metronidazole, tinidazole, trimethoprim, linezolid, and some other antibiotics should not be mixed with alcohol to avoid unpleasant side effects. And you must not abuse alcohol during the course of antibiotics - it additionally weakens the body, which does not help to fight the infection.