What are antibiotics? A brief history…
In 1928, Alexander Fleming noticed that there was a fungus growing on his bacterial culture. Around this fungus, he noticed that there were clear areas with no bacteria present. After much research into this phenomenon, he concluded that the virus, penicillium notatum, had the ability to kill the bacteria (The History of Antibiotics, N.D.). He later formulated this discovery into penicillin, and almost 100 years later, doctors and other medical providers have prescribed millions of Americans penicillin each year. Therefore he developed the first chemical that would kill antibiotics, and scientists adapted this for use in treating humans with active infections. While in the next century many more classes of these medications would have been developed, the war between antibiotics and microbes rages on.
After all according to the CDC, in 2020, clinicians wrote over 201.9 million antibiotic prescriptions (Outpatient Antibiotic Prescriptions, 2020). Most Americans have been prescribed these at least once in their lifetime, though many don’t know much about them. Therefore, we will discuss the things everyone should know about antibiotics.
Antibiotics come with Side Effects
Like all medications, antibiotics come with a long list of possible side effects, though most are mild. If an antibiotic comes with a severe possible side effect- or “black box warning”- your clinician will discuss this with you when the medication is prescribed. Many antibiotics share similar side effects. One of the most common side effects of all is nausea and diarrhea.
In summary, this happens because while they kill the bacteria making you sick, they can also kill or disrupt the bacteria that protects your gastrointestinal system. According to the Mayo Clinic, “about 1 in 5 people who take antibiotics develop antibiotic-associated diarrhea,” (Antibiotic-associated diarrhea, N.D.). Disruption causes the gut to malfunction and creates loose stools.
In addition, antibiotics can affect and interaction with other medications, including life-threatening cardiac complications and alterations in the thin-ness of blood and INR for patients on warfarin.
C Difficile Diarrhea
On rare occasions, antibiotics can cause a severe and infectious kind of diarrhea called clostridioides difficile (“c. diff” for short), so it is important to let your clinician know if you have severe diarrhea and associated symptoms such as fever, abdominal pain, and malodorous stool. Moreover, Clostridium difficile infections are difficult to treat and eradicate from the body, and require strong medications to control symptoms.
Other common side effects include rash. Accordingly, people with allergies to certain classes of these medications can develop hives or even scaling rashes (erythroderma) and Stevens-Johnsons syndrome.
Taking Antibiotics is about Risk vs Reward
Even considering the possible severe side effects of antibiotics, taking antibiotics is a great way to help your body fight off bacterial infections. Another thing that everyone should know, though, is that not all infections are caused by bacteria. Many infections are viral and antibiotics won’t be effective. For instance, the common cold and seasonal flu are both caused by viruses and thus are not impacted by antibiotics. Using them for viral infections can create resistance, which occurs “… when the germs… develop the ability to defeat the drugs designed to kill them,” (About Antibiotic Resistance, n.d). However, when there is antibiotic resistance, the list of effective antibiotic treatments for a specific infection shrinks. Therefore, it is important that we are strict about the use of antibiotics for their intended purposes, a term called “antibiotic stewardship” in healthcare.
Resources
Antibiotics. Cleveland Clinic. (n.d.). Retrieved October 25, 2021
Centers for Disease Control and Prevention. (n.d.). About antibiotic resistance. Centers for Disease Control and Prevention. Retrieved October 25, 2021, from https://www.cdc.gov/drugresistance/about.html.
Centers for Disease Control and Prevention. (2020). Outpatient antibiotic prescriptions – United States, 2020. Centers for Disease Control and Prevention.
The history of antibiotics. Microbiology Society. (n.d.). Retrieved October 25, 2021
Mayo Foundation for Medical Education and Research. (n.d.). Antibiotic-associated diarrhea. Mayo Clinic. Retrieved October 25, 2021
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This article reviewed by Ms. Deb Dooley.
There’s nothing more important than our good health – that’s our principal capital asset.
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