Antibiotics are a vital medicine to help fight infections, but they don’t cure everything, as Michelle Higgs explains
“Bacterial infections are common, and they can be mild, serious or even life-threatening. Antibiotics are often used to treat them; their job is to kill the bacteria or to prevent them from multiplying”
“You’re most likely to be prescribed antibiotics by your GP, but the important thing to remember is that you will only ever be offered them if you really need them”
Facts/stats
In 2020 in England, 72% of antibiotics were prescribed by general practitioners
(NHS England)
The most frequently prescribed antibiotic in England is amoxicillin
(NHS England)
Worldwide, at least 700,000 people die each year from infections resistant to antibiotics
(World Health Organisation)
Bacterial infections are common, and they can be mild, serious or even life-threatening. Antibiotics are often used to treat them; their job is to kill the bacteria or to prevent them from multiplying.
You’re most likely to be prescribed antibiotics by your GP, but the important thing to remember is that you will only ever be offered them if you really need them. This applies if you have an infection that isn’t serious but is unlikely to get better without treatment, for instance, acne; if there’s a chance you could infect others, for example, with a sexually transmitted infection; if there’s a risk of more serious complications, for instance, pneumonia; or if antibiotics would help speed up your recovery, for example, a kidney infection.
You may also be prescribed antibiotics if you’re more vulnerable to the effects of infections. People who fall into this category are over 75, or have heart failure, or have diabetes and take insulin for it, or have a compromised immune system because they are undergoing cancer treatment or have an underlying health condition.
Types of antibiotics
Although there are hundreds of different antibiotics, they can be grouped into five distinct categories, according to the type of infection they can treat.
Penicillins are used to treat a variety of infections including those of the skin, urinary tract and the chest. They are the most widely used antibiotic.
If you’re allergic to penicillin, you may be offered macrolides as an alternative. They can also treat lung and chest infections, or bacteria resistant to penicillin.
Tetracyclines are routinely used to treat skin conditions like acne and rosacea that are unlikely to clear up without treatment.
Cephalosporins are particularly effective for combatting serious infections like meningitis and sepsis.
Aminoglycosides are only normally used if you’re hospitalized for a very serious bacterial infection such as sepsis.
A sixth category – fluoroquinolones – has a risk of serious side effects so they are not used routinely any more.
What antibiotics can’t do
If your GP doesn’t prescribe antibiotics for you, that usually means you have a mild bacterial infection that will go away by itself and you’re not as ill as you thought! Alternatively, you could have a virus. Antibiotics cannot be used to treat viral infections such as the common cold, most coughs and flu. This can be frustrating, especially if you’re suffering with a lingering cold, but ask at your local pharmacy for advice about over-the-counter products that can help alleviate your symptoms.
Beware of the side effects
Antibiotics are powerful drugs so it’s common to experience side effects when you take them. They are usually mild and can include feeling nauseous, being sick, stomach pains and diarrhoea. However, they should disappear once the course is finished so it’s important to continue taking your antibiotics, unless the side effects are severe.
Some people experience a mild to moderate allergic reaction to antibiotics, particularly penicillin and cephalosporins. If this happens to you, you might be coughing or wheezing, have a raised itchy rash, or have tightness in your throat that could cause breathing problems. These allergic reactions can usually be treated with antihistamines, but if you’re worried contact your GP or call NHS 111.
If you do have an allergic reaction to a particular antibiotic, tell your GP or pharmacist so that it can be added to your health record. Very rarely, an antibiotic can cause a severe allergic reaction called anaphylaxis. This can be extremely life-threatening so you should call 999 or go to A&E immediately.
Interactions with other drugs/alcohol
Always tell your GP or pharmacist about any health issues, medical conditions or allergies to certain antibiotics, so that they can prescribe the most suitable one for you. The same advice applies to women who are pregnant or breastfeeding.
Drinking alcohol while taking a course of antibiotics can worsen the common side effect of feeling sick. In addition, with some types of antibiotic, you may feel extra side effects such as dizziness, headaches, hot flushes or an irregular heartbeat if alcohol is drunk at the same time. Other antibiotics are made less effective if taken with alcohol. Check with your GP or pharmacy about alcohol and your prescribed antibiotic.
The effectiveness of the contraceptive pill can be reduced by some antibiotics. Again, ask for advice about this, particularly whether you should use extra contraceptive protection while taking the course.
5 tips for taking antibiotics
- Follow the specific instructions on the packaging. Every antibiotic is different, so you might need to take them on an empty stomach, or with food.
- Always finish the course to get the most from the treatment. If you’re not sure about the dose or how you should take the antibiotics, ask at your local pharmacy.
- Never give leftover antibiotics to someone else; they are prescribed for you and your specific infection.
- Always take unused antibiotics back to the pharmacy where they can be disposed of safely.
- After a course of antibiotics, try taking a probiotic supplement to restore your gut bacteria balance.
Antibiotic resistance
Source: World Health Organisation
Antimicrobials – including antibiotics, antivirals, antifungals, and antiparasitics – are medicines used to prevent and treat infectious diseases in humans, animals and plants.
Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial medicines. As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness, disability and death.
AMR is a natural process, but it is accelerated by human activity, mainly the misuse and overuse of antimicrobials to treat, prevent or control infections in humans, animals and plants.
What has this got to do with me?
Source: Antibiotic Research UK
There are lots of things that individuals can do to help prevent global antibiotic resistance. Overcoming the threat of antibiotic resistance requires cooperation between patients, the general public, healthcare providers, farmers and policy makers around the world.
Top tips for preventing the spread of antibiotic resistance
- Wash your hands properly using soap regularly. Antibacterial soap is probably no better than general purpose soaps, so don’t let the lack of one put you off
- Cover your mouth with a tissue when sneezing or coughing and dispose of the tissue immediately. If you don’t have time, cough into the crook of your elbow. Don’t cough into your hand or keep a hanky in your pocket!
- If your symptoms are mild (e.g. sore throat), don’t go straight to your GP – go to your pharmacy for advice as your first port of call.
- Don’t ask your doctor for antibiotics if you have a cold or the flu, or any other viral or fungal infections. Trust them if they say antibiotics will not work for your illness.
- Take antibiotics exactly as prescribed by your healthcare provider.
- Keep taking your prescribed antibiotics for as long as they are prescribed for, even if your symptoms clear up sooner.
- Never borrow antibiotics or give them away to someone else, even if their symptoms are the same as yours.
- Dispose of any old antibiotics properly (e.g. at a pharmacy).