Antibiotics

When used properly, antibiotics save countless lives across the globe each day.

The role of antibiotics

Antibiotics are used extensively in modern-day medicine to treat bacterial diseases and infections including otitis, bronchitis, sinusitis, and even once fatal diseases such as tuberculosis and pneumonia. Antibiotics though are ineffective against viral diseases such as the common cold and the flu. Since it is difficult to differentiate viral infections from bacterial infections, you should see your doctor. He will be able to advise you on the most suitable treatment. It is especially important that you not demand or expect your doctor to prescribe antibiotics at the first sign of infection. As previously mentioned, antibiotics have no effect on viral infections and will not improve your symptoms.

The efficacy of antibiotics

Antibiotics are effective when chosen and used properly. To effectively treat a specific infection, the right antibiotic must be chosen. For example, a product that is highly effective against a dental infection may be utterly ineffective against a sinus infection. Efficacy also involves the proper use of antibiotics. This simply means that taking medication at the right time and as often as prescribed is key. Lastly, when taking antibiotics, it is important to continue until the end of the prescribed course, even if you are feeling better after a few days. Patients who fail to finish their treatment may see the infection recur which will involve another course of treatment. We would like to stress the importance of respecting the instructions given to you by your doctor or pharmacist when it comes to taking your antibiotics.

What about resistant bacteria?

Bacteria is said to be resistant when it reduces or eliminates the effectiveness of an antibiotic. You may encounter situations where, in spite of following the doctor's and the pharmacist's orders to the letter, the prescribed treatment fails to eliminate the bacteria. In such cases, we can assume that the bacteria are resistant to the selected antibiotic. Some bacteria protect themselves against certain antibiotics naturally, while others adapt themselves against antibiotics that are used improperly. Improper use of medication includes stopping your medication before finishing the full course - only to see the infection reappear, or taking antibiotics for viral infections. A new medication must then be prescribed in order to eradicate the bacteria. These types of problems are on the rise.

What about allergies?

If you develop a red rash on your face or body, swelling or itching, you are probably experiencing an allergic reaction to your medication. Drug allergies can be severe and should always be taken seriously. If you think you are having an allergic reaction to your medication, stop taking it and seek medical help at once. If an allergy is confirmed, the doctor will most likely prescribe a different antibiotic.

Adverse effects associated with antibiotics

Our bodies are host to countless microorganisms, including bacteria and fungi, which help maintain a healthy balance in what is known as the normal flora. The flora is what protects us against microbes that can make us sick (pathogens). Taking antibiotics can disrupt the normal flora which may lead to superinfection by a pathogenic microorganism. Below are two examples of what can happen when there is an imbalance in the normal flora resulting from the use of antibiotics.

Diarrhea
While traveling through the bowels, antibiotics can affect the normal flora, resulting in mild diarrhea. Generally speaking, the diarrhea is usually not severe enough to justify stopping treatment. To prevent this from happening, you may want to consider taking probiotics. Probiotics are sold at your local pharmacy - see your pharmacist for more information.

In some people, approximately 5% of the population, the Clostridium difficile bacteria may colonize the bowel. The bacteria is commonly spread by infected persons through hand contact and is usually harmless to humans. However, when we take antibiotics to treat an illness for example, the medication disturbs the natural balance and allows the bacteria to multiply, making it more harmful. A superinfection with bacteria like C. difficile causes watery diarrhea, fever, abdominal pain, dehydration and nausea. We recommend that you see your doctor if you experience these symptoms even if they appear a few days after you have finished your antibiotics. Some people are at greater risk for developing a superinfection. These include the elderly, those with compromised immune systems, those who were recently hospitalized or recently underwent gastrointestinal surgery, those who have chronic diseases of the colon and those who have already been infected.

Yeast infections
For many women, taking an antibiotic can disrupt the natural flora in the vagina or vulva and cause a yeast infection (candidiasis). If this occurs, using an appropriate cream or suppository for vaginal yeast infections is recommended. Your pharmacist can advise you on the right product. Probiotics may also help prevent yeast infections.

Other than these inconveniences, most antibiotics are generally well tolerated and do not cause major adverse reactions.

In its latest publication, the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends that oral contraceptive users be advised that taking antibiotics (except griseofulvin and rifampine) does not appear to affect the efficacy of oral contraceptives.

Antibiotics can interact with other medications. It is important that you let your pharmacist know if you are taking other medications or natural products.

Antibiotics for children

When children are prescribed antibiotics, it is extremely important to know their exact weight so they can be given the proper dose. Too small a dose may be ineffective while too large a dose may increase the child's risk of developing an adverse reaction.

Paediatric antibiotics are available in liquid form and some are even available in chewable tablets. Let your pharmacist know what your child prefers. If possible, he will provide you with a form and flavour that is sure to please your child.

Normally, the pharmacist includes a measuring device (syringe or cup) to ensure exact dosing. Using this device is very important as it will serve to take sure that you are giving your child the proper dose every time. Also, always shake suspensions before using to ensure redistribution of the drug that may have deposited on the bottom. Failure to shake the medication may result in administering the wrong dose. Suspensions should be kept in the refrigerator or at room temperature. Your pharmacist can advise you on how to best store your medication.

Remember that the entire course of the antibiotic should be completed. Always discard any remaining medication once the course is completed. Suspensions expire after a few days and must never be used beyond the expiry date on the label.

** Important: Any time you consult a new doctor or pharmacist, it is important that you mention any drug allergies. **