Since the first discovery of penicillin, antibiotics have been a useful and beneficial tool in fighting a wide variety of bacterial infections. But antibiotics must be used wisely and safely and only used when medically necessary in order to get the most benefit from them. For the last decade or more, health care professionals have been concerned because antibiotics have been over-prescribed, overused and misused for so long that many of them are losing their ability to fight illnesses. Many types of bacteria have already become resistant to some of the older “first-generation” antibiotics making them almost useless against some illnesses. New antibiotics are being developed but bacteria can adapt and become resistant to them to them too, if they are not used carefully. Doctors are trying to their part to stop antibiotics from being overused by not prescribing them unnecessarily. We can help, too, by learning more about these “miracle drugs” and how to use them properly and safely.
What Do Antibiotics Do?
Antibiotics fight bacteria. (Think of them as “bacteria-busters”!) There are many different kinds of bacteria that cause many different illnesses. Because of the wide variety of bacteria, there is also a wide variety of antibiotics that have been developed to treat them. When your doctor diagnoses a bacterial infection she will determine which antibiotic is appropriate for that particular infection.
If your doctor diagnoses a bacterial infection, ask her if it is absolutely necessary to use an antibiotic. Some bacterial infections can be cleared up without antibiotics when under a doctor’s supervision. For example, antibiotics used to be routinely and automatically prescribed for ear infections in young children. However, research has shown that many of these infections can heal on their own without antibiotics as long as a doctor is monitoring the infection. Talk with your doctor about the necessity of using an antibiotic, the pro’s and con’s of using one versus not using it, then follow her advice and directions.
Not all infections are bacterial. Most common, minor illnesses are caused by viruses. Viral and bacterial infections may share some of the same symptoms but they are very different infections and must be treated differently. If your doctor diagnoses a viral infection, it is unwise to pressure her into giving you a prescription for an antibiotic because antibiotics are useless against viruses. It would be a waste of money and would contribute to the problem of resistant bacteria due to antibiotic misuse.
When You or Your child is Prescribed an Antibiotic
The questions that you need to ask your doctor include:
- The name of the medicine (both brand name and generic name)
- The amount to be given (dosage)
- The times to be given (schedule)
- Possible side effects
- Potential drug interactions with any other medicine you are taking
- When to call or come back in if symptoms have not improved
Be sure that the doctor is aware of any other medications (including over-the-counter medications and herbal supplements) that are being used. If the antibiotic is for your child, ask about the taste and if it can be mixed with juice or food to disguise a bad taste. (We have been blessed with a pediatrician who tastes tests medicines so he can be honest with his patients about whether they are yucky or not. And if he has a choice of what to prescribe, he gives them the best tasting one.)
When You Go to the Pharmacy
Ask the pharmacist to give you written instructions on:
How long you need to take it for (most of the time you will continue until all of the antibiotic is gone)
How much to take (dosage)
Also ask whether or not the medicine:
Can be taken with or without food
Needs to be refrigerated
Needs to be shaken well (if a liquid)
Can be mixed with food or liquid to disguise a bad taste
Make sure the name of the medicine and the amount and times to be given on the label match what your doctor told you. Liquid medications need to be measured precisely, ask for a measuring device if you don’t have one. If other medications/supplements are being used, tell the pharmacist and ask about drug interactions. Some medications can be dangerous when mixed.
Taking or Giving the Antibiotic at Home
When giving or taking the antibiotic at home, make sure to stick as closely as possible to the scheduled times. If a dose is missed, do not double dose. If it is almost time for the next dose, then do not take the skipped dose, just take the next one on time. If it is still a few hours until the next dose, take the skipped one and then adjust the time to take the next one accordingly. If two or more doses have been skipped, call your doctor for instructions. Always call the doctor or pharmacist if you have questions.
Be sure to use a medication measuring cup, dropper, or oral syringe for liquid medications. Kitchen teaspoons and tablespoons can vary widely so don’t use them to measure medicine. (I wonder how many times we got the wrong dose when our moms gave us medicine using kitchen spoons?) Do not cut pills in half or crush them unless you have been told to or have checked with the pharmacist first because it could alter the effectiveness. Do not mix the antibiotic with juice, milk, or anything else to make it taste better unless the pharmacist says that it is okay to do so because certain antibiotics have to be taken on an empty stomach. Also, calcium and vitamin C can lessen the effectiveness of some antibiotics.
Always finish all of the prescribed antibiotic unless the doctor has instructed otherwise. Just because the symptoms may be alleviated after a few doses and you feel better, it does not mean that the infection is completely gone. Not finishing an antibiotic allows the remaining bacteria to learn how to adapt to the antibiotic and become resistant against it.
Common side effects of most antibiotics include: mild diarrhea, nausea, abdominal discomfort, and headaches. All antibiotics have the potential for side effects but that does not mean that every person will have the same ones. Most of the time, side effects are mild. If you have side effects that are moderate to severe, contact your doctor or pharmacist. Don’t stop using the medication without checking first. If your doctor instructs you to stop taking the medicine before it is finished, throw out the remaining amount. Do not save it for another illness.
Keep antibiotics (and, of course, all other medications) out of the reach of children. Put them in a cool, dry, dark, safe place or if it needs refrigeration, put it on the highest refrigerator shelf. Bathroom medicine cabinets are exposed to too much humidity which can lessen the effectiveness of some antibiotics.
If you have leftover antibiotics in your medicine cabinet, do not use them. Using or giving an antibiotic to one person that has been prescribed for another person can be very dangerous, even life-threatening. You would not have a full course of treatment and the antibiotic may not even be effective against the specific bacteria causing your illness. Instead, ask your pharmacist how to properly dispose of any leftover antibiotic. Do not throw any medicine in the trash because small children and pets could have access to them there.
When All the Medicine is Gone
Hopefully you will be feeling much better by the time you have finished all of your antibiotic. If, however, your symptoms haven’t cleared up and you are still feeling sick, call your doctor. She may want you to come back in for a re-check visit or she may call in a different, stronger antibiotic for you.
These guidelines are of a general nature and not intended to replace the advice and supervision of your physician or pharmacist.