Everything You Need to Know About Taking Antibiotics
Prescription antibiotics have a wide range of uses, from treating sinus infections to keeping cuts clean as they heal. But before you assume they're the cure for what's ailing you, study up on these key queries, which we asked a doctor.
When do you need an antibiotic?
Antibiotics come in several forms—most often pills, but also liquid, ointment, and IV formulas—but all have the same purpose. "Antibiotics are medications that specifically treat bacterial infections," says Jennifer Cohn, M.D., assistant professor of clinical family medicine and community health at the University of Pennsylvania. "The goal of all antibiotics is to stop the spread of a certain bacteria that is causing an infection, and different kinds do this in different ways." Common antibiotics include amoxicillin, Augmentin, and penicillin, which treat sinus infections, strep throat, and many other infections; nitrofurantoin and sulfamethoxazole-trimethoprim, more commonly known as Macrobid and Bactrim, prescribed for urinary tract infections; and azithromycin, doxycycline, and metronidazole, which are popular for the treatment of sexually transmitted diseases.
Do you need a prescription for antibiotics?
Except for over-the-counter products that prevent infections in cuts and scrapes, you'll need doctor to prescribe antibiotic treatments, says Dr. Cohn, but this also provides you with an opportunity to discuss other medications you're taking. "Most antibiotics do not interact with other medications, including birth control, but it is important to review your medications with your doctor in case there is a small risk of interactions," she explains. "Alcohol generally does not cause interactions with antibiotics—with a few important exceptions—but excessive alcohol use may decrease how well the antibiotic works and how well your body is able to fight off the infection."
Are there illnesses antibiotics can't help?
Antibiotics are helpful, but not a cure-all. "Antibiotics do not work on viral infections, like colds, or fungal infections, like yeast infections," notes Dr. Cohn. "If you have a viral infection, like a bronchitis, some sinus infections, or a stomach bug, antibiotics will not work. This is why it is so important to see a clinician before starting an antibiotic to make sure it is necessary, and if not, get information on other things you can do to feel better."
Are there side effects to antibiotics?
Your doctor will likely suggest taking antibiotics with food, which lowers the possibility of gastrointestinal side effects—like cramping, nausea, or diarrhea—or might offer a probiotic supplement to take alongside the antibiotic. Antibiotics can also cause yeast infections, easily treated with an over-the-counter pill or prescription remedy. "If you are prone to yeast infections from antibiotics, it is reasonable to ask your provider to prescribe you a yeast medication to take after you finish the course," explains Dr. Cohn. "All medications have a risk of side effects, but typically the benefit of taking the antibiotic outweighs the risk, and the risk of side effects are small, especially when taken properly."
Should you keep taking an antibiotic even if you feel better?
A course of antibiotics usually spans several days, and though you might start feeling well again after the first 24 to 48 hours, you shouldn't give up on the rest of the treatment. "When a doctor prescribes a certain antibiotic, it is intended to treat a specific infection and it is important to take the whole course as prescribed," says Dr. Cohn. "Once you are feeling better, you should finish the entire course because if not, in the future, that same antibiotic might not work due to resistance." If you do end up with a few extra pills, return them to the pharmacy or your doctor's office, says Cohn—don't keep them around for your next infection. "They might not work, and they may make your body more resistant to them in the future," she continues, "and you should be evaluated by a clinician to determine if you even need an antibiotic."
What if you don't feel better?
Signs that you need to touch base with your doctor after starting antibiotics include a "significant allergic reaction," says Dr. Cohn, "such as hives, swelling, wheezing, or severe nausea or vomiting." If your symptoms don't improve—or if they worsen—that's also a signal that you should check in. "If your infection does not appear to be getting better after one to two days of treatment, you may need a different or stronger antibiotic," she shares. "Even simple infections like urinary tract infections can become serious and require hospitalization if not treated appropriately, so taking your antibiotic as prescribed and keeping in contact with your provider if you aren't feeling better is really important."
When should you decline an antibiotic?
Though antibiotics are safe and effective ways to fight bacterial infections, you shouldn't feel pressured to take a prescription you don't want to. "If you aren't comfortable with the treatment that is recommended for you, I encourage you to voice your concerns and ask for an alternative if possible—it is your body and your right to ask questions," says Dr. Cohn. "Depending on the infection, sometimes it is reasonable to 'watch and wait' to see if things get better on their own before starting an antibiotic. If the infection is severe or has a risk of becoming serious, your provider will likely encourage you to start the antibiotic right away."