Antibiotics: Risks, Resistance, and Proper Use

Q: Antibiotics: Risks, Resistance, and Proper Use

Dear Ms. Chen： 1. The use of antibiotics is generally recommended to follow a complete course, which varies depending on the disease, typically ranging from 5 to 7 days. However, certain conditions may require treatment for two weeks or even four weeks. Clinici

Antibiotic Issues

Last night, I went to the doctor and was diagnosed with bronchitis.
I took a packet of medication home.
This morning, I had to wake up early for work and didn't have time to take the medication again.
It wasn't until now that I realized the doctor prescribed antibiotics.
I've heard that antibiotics can easily lead to antibiotic resistance.
If I only took one dose of the medication and didn't continue, is there a risk of developing resistance? Should I resume taking the medication or go back to see the doctor? Are there any foods I should avoid while taking antibiotics?

Ms. Chen, 10~19 year old female. Ask Date: 2020/10/09

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Chen:
1.
The use of antibiotics is generally recommended to follow a complete course, which varies depending on the disease, typically ranging from 5 to 7 days.
However, certain conditions may require treatment for two weeks or even four weeks.
Clinicians must prescribe an appropriate antibiotic regimen based on the progression of the illness and the patient's response.
Discontinuing the medication prematurely can lead to the selection of antibiotic-resistant bacteria among the pathogens.
These bacteria can acquire plasmids that carry resistance genes, which can then be transferred to other non-resistant bacteria, ultimately resulting in the widespread emergence of antibiotic-resistant strains that can continue to spread or infect other individuals.
Although the development of antibiotics is rapidly advancing, it cannot keep pace with bacterial mutations.
If physicians misuse antibiotics or patients do not adhere to prescribed regimens, humanity may face a future without effective antibiotics.
This is why the global medical community places significant emphasis on the regulation and appropriate use of antibiotics.
2.
Each class of antibiotics may have specific usage guidelines; some need to be taken on an empty stomach, some should not be taken with milk, some cannot be combined with antihistamines, some should not be used with cholesterol-lowering medications, some are contraindicated in children, some are not safe for pregnant women, some may cause allergic reactions, and there are distinctions between lipophilic and hydrophilic antibiotics, among others.
3.
I speculate that if you are consulting with a general practitioner, the antibiotics prescribed are likely to be first-line agents.
If resistance develops, there are still second-line antibiotics available.
If you have any questions regarding your antibiotic treatment, I recommend discussing them with your attending physician before making any decisions.

Reply Date: 2020/10/09

More Info

Understanding antibiotics, their risks, resistance, and proper use is crucial for effective treatment and minimizing potential complications. Antibiotics are powerful medications designed to combat bacterial infections, but their misuse can lead to significant health issues, including antibiotic resistance.

Risks of Antibiotics
Antibiotics can cause various side effects, which may range from mild to severe. Common side effects include gastrointestinal disturbances such as nausea, vomiting, diarrhea, and abdominal pain. Some individuals may experience allergic reactions, which can manifest as skin rashes, itching, or, in severe cases, anaphylaxis. Additionally, antibiotics can disrupt the natural balance of bacteria in the gut, leading to conditions like Clostridium difficile infection, which can cause severe diarrhea and colitis.

Antibiotic Resistance
Antibiotic resistance occurs when bacteria evolve and become resistant to the effects of medications that once effectively treated them. This phenomenon can arise from several factors, including the overuse and misuse of antibiotics. When antibiotics are taken improperly—such as not completing a prescribed course or using them for viral infections—bacteria can adapt and survive, leading to resistant strains. This makes future infections harder to treat and can result in longer hospital stays, higher medical costs, and increased mortality.

Your Situation
In your case, if you have taken only one dose of the antibiotic prescribed for bronchitis and have not continued the treatment, the risk of developing antibiotic resistance is relatively low. Resistance typically develops after prolonged exposure or inappropriate use of antibiotics. However, it is essential to follow your doctor's instructions regarding medication. If your doctor prescribed a full course of antibiotics, it is generally recommended to complete the entire course, even if you start feeling better. Stopping early can allow some bacteria to survive and potentially develop resistance.

Next Steps
Given that you missed a dose and are unsure about continuing the medication, it would be wise to consult your healthcare provider. They can assess your condition and determine whether you should resume the antibiotic or if a different treatment approach is necessary. If you are experiencing worsening symptoms or new side effects, seeking medical advice promptly is crucial.

Dietary Considerations
When taking antibiotics, certain dietary considerations may enhance or hinder the effectiveness of the medication. For example, dairy products can interfere with the absorption of some antibiotics, particularly tetracyclines and fluoroquinolones. It's advisable to avoid consuming dairy products, antacids, or iron supplements within a couple of hours before or after taking your antibiotic. Additionally, alcohol should generally be avoided while on antibiotics, as it can exacerbate side effects and reduce the effectiveness of the treatment.

Conclusion
In summary, while the risk of developing antibiotic resistance from a single missed dose is low, it is essential to adhere to your prescribed treatment plan. Consult your healthcare provider for guidance on whether to continue the antibiotic or seek alternative treatments. Always be mindful of dietary restrictions associated with your medication to ensure optimal effectiveness. By understanding the proper use of antibiotics and their potential risks, you can contribute to better health outcomes for yourself and help combat the growing issue of antibiotic resistance in the community.

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