Alcohol and Antibiotics

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A 2018 CDC report shows that in the US, 270.2 million prescriptions for antibiotics were written in 2016. These are crucial for treating various infections, but it’s likely that alcohol, a common substance consumed by many adults, can interfere with their efficacy. Here’s how alcohol can affect antibiotics, along with the major risks and side effects of taking them together.

What Are Antibiotics?

Antibiotic medications are antibacterial agents that hinder or prevent the growth of bacteria. Antibiotics are used to cure bacterial diseases instead of viral infections such as the common cold and the flu. Antibiotics prevent antibodies from reproducing or killing the invading bacteria. Although the body’s white blood cells can address the infection by attacking harmful bacteria, the number of foreign bacteria can be too much for the body to handle on its own, requiring assistance from antibiotics.

There are different kinds of antibiotics available to treat various conditions, like sepsis, STIs, UTIs, bacterial pneumonia, and strep throat.

Side Effects of Antibiotics

When you take antibiotics as prescribed, they’re usually safe. But at the same time, many antibiotics are accompanied by the risk of side effects such as diarrhea, nausea, and an upset stomach. So, when you consume alcohol, the risk of these side effects also goes up, and you face the risk of additional side effects like headaches, drowsiness, and vomiting.

Mixing Alcohol and Antibiotics

There are various warnings on the packaging of antibiotic medication that you shouldn’t have alcohol with them. But even so, there’s a misconception that having alcoholic beverages along with the medication is harmless. Patients often ask healthcare professionals whether it’s safe to have alcohol while taking these medications. It’s not safe, and that’s because the alcohol had a direct influence on how effective the antibiotics are, while causing other adverse side effects.

When the liver breaks down alcohol, it produces acetaldehyde, which can lead to nausea. People on a round of antibiotic medication already experience digestive upset, so drinking alcohol can worsen feelings of nausea. And it’s not just gastrointestinal function that takes a hit; alcohol can impact your coordination, concentration, and cognitive function.

More importantly, alcohol can hinder crucial processes of the body, such as hydration and sleep, both of which are important when you’re recovering from a bacterial infection. So all factors considered, it’s best to avoid alcohol consumption when receiving antibiotic treatment.

The Interaction between Alcohol & Anti-biotics

Our bodies use the same enzymes to metabolize certain antibiotic medications and alcohol as well. So by drinking, you keep those enzymes from metabolizing the medication. This increases the risk of side effects, and other issues, such as alcohol and an antibiotic having the same side effect. Because of this, taking them in conjunction can have dangerous effects. For instance, metronidazole and other antibiotics that cause discomfort to the stomach have a depressive effect – same as alcohol. Thus, mixing them together leads to an even stronger effect, which can potentially cause accidents due to limitations in coordination.

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Major Side Effects

When you mix both antibiotics and alcohol, there’s no one single side effect that you can expect. Based on the antibiotic your doctor prescribed, alcohol consumption can affect how it works, causing it to become less potent or build up in a way that causes toxicity. Here are some of the most major consequences:

Potential Liver Damage

Antibiotic medications like ketoconazole and isoniazid are used very rarely, such as to treat fungal infections and tuberculosis, but have dangerous side effects. When you take them with alcohol, it causes a reaction similar to that of disulfiram, which is used to develop an aversion to alcohol. However, these drugs on their own can risk causing liver damage, and combining them with alcohol increases that risk.

Signs of liver damage include abdominal pain, dark colored urine, and nausea. More prominent signs include chronic fatigue and a yellow tint in the eyes.

How it happens
Both these antibiotics become toxic when they’re broken down in the liver. Additionally, alcohol consumption can lead to liver damage when there’s too much for the liver to break down, causing toxins to build up. It becomes very risky when the liver isn’t working at full capacity or is processing other medications at the same time.

Abdominal and Heart Effects

Antibiotics like sulfamethoxazole and some cephalosporinscan cause serious reactions with the gastrointestinal tract and heart if you take them with alcohol. And this doesn’t only refer to alcoholic beverages like beer or wine, but alcohol-containing products like cough syrups and mouth washes as well.

When you take them with alcohol, these antibiotics reduce your body’s tolerance to it, leading to symptoms such as sweating, anxiety, and fluctuations in blood pressure.

How it happens
Healthcare professionals refer to the above-mentioned symptoms as disulfiram-like reaction. That’s because disulfiram is a medication used to discourage alcoholics from drinking. Usually, the liver metabolizes alcohol by converting it into acetaldehyde, which has a toxic effect. Then, it’s converted to acetate.

The same way as disulfiram, certain antibiotic medications cause acetaldehyde in the body, which cause the symptoms mentioned above.

Alcohol as a Risk Factor in Healing from Infections

Due to the interaction between alcohol and antibiotic medications as mentioned above, people suffering from alcohol dependency suffer from a higher risk of infections. Alcoholism is also associated with a higher co-occurrence of delay in wound closure and infection. Alcoholics also face a higher risk of Staphylococcus aureus infection, such as Vibriumvulnificus, Streptococcus pyogenes, and methicillin-resistant Staphylococcus aureus.

Besides antibiotic-alcohol interactions, excessive alcohol consumption has a direct effect on the immune system. One of the ways it hinders with the body’s immune functions is by changing the number of helpful bacteria in the gut, which are essential for immunity.

Similarly, alcohol can damage the stomach’s outer layer of cells, causing bacteria to leak from the gastrointestinal tract and into the bloodstream. Not to mention, heavy alcohol consumption is associated with low levels of T cells and B cells, which are important antibodies used to detect infections.

Don’t Skip Doses To Drink Alcohol

Even if you’d like to have a drink, it’s crucial that you don’t skip a dose until you’ve completed the prescribed antibiotic course. Moreover, skipping a single doze won’t really reduce the side effects you experience, as it takes a few days before the medication is entirely out of your system.

When you start taking antibiotics, you end up feeling better after 2 days of doses. However, it doesn’t signal that there’s no longer a bacterial infection. So skipping a dose gives the bacterial infection a chance to return.

If you or a loved one is suffering from alcohol addiction and has to receive medical care for a bacterial infection, speak to your healthcare provider about your drinking habits first.

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Bryan Alzate
Written by:
Bryan Alzate serves as United Recovery Project Chief Executive Officer. Bryan has a vested passion in assisting those struggling with substance abuse. He is an active member of the recovery community with over 13 years substance abuse free. Bryan attended Florida Atlantic University before co-founding United Recovery Project. Bryan brings 10 years of substance abuse treatment experience to URP. It is his mission to provide a safe & healing environment where clients are given the tools necessary to achieve total health and wellness within their recovery journey.