Should I finish my antibiotic course?

Proper use of antibiotics

What are antibiotics?

Antibiotics are naturally formed metabolites of fungi and bacteria. The word antibiotics comes from the Greek and means "against life". Ultimately, however, it is only bacteria that affect the collar. Their growth is inhibited or killed. Antibiotics, which are obtained either synthetically or biotechnologically, are used today for drug therapy.

What are they used for?

Antibiotics are used to fight infections caused by bacteria. Bacteria are virtually everywhere and come in a myriad of types and forms. But they don't all make us sick. In fact, many are extremely useful. For example, they serve us well with digestion.

Unfortunately, because antibiotics cannot differentiate between "good" and "bad" bacteria, they also kill the useful ones. This can upset the intestinal flora, for example.

What antibiotics are there?

There are a wide variety of antibiotic substances available. The most important are:

  • Penicillins with a broad spectrum of activity
  • Penicillins with a narrow spectrum of activity
  • Cephalosporins
  • Sulfonamide combinations
  • Tetracyclines
  • Macrolides
  • Aminoglycosides
  • Gyrase inhibitors

Why don't antibiotics help against colds?

Colds, like the flu, are viral infections. Antibiotics are absolutely powerless against viruses. This is because antibiotics intervene in the metabolism of bacteria. Viruses, on the other hand, have no metabolism of their own, but use a host cell to multiply. They offer practically no point of attack for antibiotics.

Nevertheless, even with a cold, it may be necessary for the doctor to prescribe an antibiotic. This is always the case when an additional bacterial infection occurs during the course of a cold. Doctors call this one Super infection. Typical examples of this are the purulent runny nose, sinus suppuration after a cold or sore throat with high fever and purulent sputum. If bacteria are involved, they are mostly streptococci, which can cause severe consequential damage, e.g. to the heart or kidneys.

Why are they prescribed too often?

About 40 to 60 percent of antibiotic prescriptions are wrong prescriptions, according to Dr. Michael Kresken from the Paul Ehrlich Society. In every second case, they are prescribed for no reason, usually for harmless infections such as runny nose or cough. The reason: Many doctors shy away from the effort that a blood test or a smear brings with it. They prescribe prophylactic antibiotics without clarifying which pathogen is present and which antibiotic would help best.

But the expectations of the patients also lead many doctors to prescribe quickly: Many patients ask for antibiotics because they do not want to go home without a well-effective drug.

What can be the consequences of careless handling?

Antibiotics are no longer effective for many bacteria because the pathogens have already become resistant. In the outpatient setting, this happens most often because the patients are not taking their medication in sufficient doses or at the correct time interval. Many stop taking the medication as soon as they feel better. The problem: Resistant bacteria can survive and become insensitive to the drug. They are helped by the fact that the antibiotic has already damaged the intestinal flora and the mucous membranes and these are now an ideal breeding ground for the resistant germs to spread.

As the bacteria become more and more resistant to antibiotics, we have to rely on the pharmaceutical industry constantly developing new antibiotics - a race against time.

Resistant germs are a particularly big problem in hospitals.

How do you take antibiotics correctly?

There are a few important rules to follow when taking antibiotics:

  • An antibiotic should always be taken for as long and in the dose as the doctor has prescribed. If the process is terminated prematurely, not all bacteria are killed; those that are still present can develop resistance.

  • The prescribed intervals between ingestions should be adhered to in order to ensure an even level of active ingredients. So "three times a day" means: one dose every eight hours.

  • If you have forgotten a tablet, it depends on the time until the next intake, whether you have to take the forgotten one later. You can find more detailed information on this in the package insert.

  • Some antibiotics are impaired in their effectiveness by calcium. They should therefore not be taken with milk or calcium-rich mineral waters. The same goes for alcohol: it limits the effectiveness of the antibiotic. Ideally, the tablets are taken with a large glass of water. There should be at least two hours between consuming milk / dairy products and taking antibiotics.

  • Some antibiotics must be taken on an empty stomach, others with food. The doctor and pharmacist explain exactly when the individual medication should be taken.

  • Anyone taking other medications should speak to their doctor about possible interactions.

What are the side effects?

As a rule, antibiotics are well tolerated. The main side effects are allergies, especially so-called allergies Drug eruption with rashes all over the body. But disorders of the intestinal flora can also occur. This can lead to loose stools and diarrhea. Fungal infections often develop in women after therapy.

What can be done to reduce the side effects?

There is currently no precise research into the long-term effects of antibiotics on the intestine. In order to support the intestinal flora during the treatment, you can fall back on special preparations from the pharmacy, e.g. yeast cultures from Saccharomyces boulardii or bacterial extracts from Lactobacillus rhamnosus. There are positive study results for these preparations (D'Souza AL, Rajkumar C, Cooke J et al. Probiotics in prevention of antibiotic associated diarrhea: meta-analysis. BMJ 2002 [June 8]; 324: 1361-4).

Women who frequently suffer from fungal infections after taking antibiotics can use suppositories with lactic acid bacteria to protect the vaginal flora.

Status: 02.11.2015, 8 a.m.