Antibiotics

Antibiotics are medicines for combating bacteria that have caused an infection in the body. Antibiotics only work with bacterial infections; infections caused by a virus cannot be fought with them. In addition, there are different types of antibiotics for different types of bacteria.  

What are antibiotics? 

Antibiotics are medicines used to kill or inhibit bacteria that have multiplied in our bodies and caused an infection there. Bacteria cannot be seen with the naked eye, but we come into contact with them every day. Still, we do not always get sick. This is because our immune system protects us and because these intruders are not always malicious; our bodies always contain bacteria that do useful work for us. In this way they digest food in our intestines and stop harmful intruders on the skin. But if pathogenic bacteria enter the body and you have insufficient resistance to fight them, you become ill. Then they can multiply very rapidly and cause an infection such as pneumonia. This often goes hand in hand with a fever. Pneumonia or heart valve infection can be fatal if no antibiotics are administered. The body is then hardly able to recover from this disease itself. Antibiotics can therefore be life-saving. However, they only work with bacterial infections. Infections caused by a virus, such as a cold or stomach flu, cannot be fought with them. And sometimes bed rest or other simple measures are enough to get better, then a doctor does not prescribe antibiotics. 

It depends on the symptoms and the type of bacteria which antibiotic is suitable to fight an inflammation. Sometimes it is necessary to send urine or pus to a laboratory to determine which bacterium causes the infection and which antibiotic is needed. Each bacterium is constructed in a different way. Examples of antibiotics are: 

  •  penicillin 
  • minocycline 
  • doxycycline 
  • ciprofloxacin 
  • claritromycin 

In general, antibiotics can be divided into narrow and broad spectrum. Small-scale antibiotics are specific for infections of a certain group of bacteria. Broad-spectrum antibiotics combat several types of bacteria at the same time. Doctors prefer to prescribe narrow-spectrum antibiotics because they kill less good bacteria during treatment. This reduces the number of side effects. But they can only be prescribed if the type of bacteria that causes the inflammation is known. If this is not known, broad-spectrum antibiotics are a good alternative because they kill several different types of bacteria. The disadvantage of this is that more side effects such as gastrointestinal complaints can occur because the good bacteria in the intestinal flora are also fought.  

The location of the inflammation in the body is also important for the choice of a particular antibiotic. For example, certain tissues are more or less sensitive to a certain type of antibiotic. The doctor should choose an antibiotic that can penetrate into the tissue.  

When do you use antibiotics? 

An antibiotic treatment is prescribed for, among other things: 

  • cystitis 
  • urinary tract inflammation 
  • throat inflammation 
  • chlamydia infection 
  • lung inflammation 

Antibiotics are always prescribed by your doctor and he or she will only do so when really necessary, for example because you do not have enough resistance to fight the infection alone. Doctors do not want to prescribe antibiotics too quickly because they want to prevent resistance to them. This means that the bacterium adapts and becomes insensitive to the effects of the medicine. As a result, this particular type of antibiotic can no longer be used to combat this bacterium, not even in other patients. In addition, bacteria can gradually become resistant. This is particularly the case if the same type of antibiotic is used repeatedly or over a long period of time. Antibiotic resistance thus creates dangerous situations, in the worst case bacterial infections can no longer be treated in the future, which in some cases can be life-threatening. 

Since antibiotics only kill bacteria and no viruses, a doctor does not prescribe this medication if you have a flu, a cold or chicken pox. Always take the medication according to your doctor's instructions and complete the course, even if you feel better after a few days. Otherwise, it is possible that the infection will recur, because not all bacteria have been combated yet. A cure takes about 5 to 10 days, depending on the type of infection. 

How do you use antibiotics? 

When, how often and how many antibiotics you should take depends on the type of antibiotic, the severity and location of your infection and your body weight. Your doctor will give you more information about this, as well as the instructions in the package leaflet. If you have any questions, please feel free to contact your attending physician. 

The antibiotics tablets or capsules are best taken sitting or standing up with a little water. If you have difficulty swallowing large tablets or capsules, keep your head slightly forward. After taking the medicine, drink a large glass of water so that it quickly reaches the stomach. Some antibiotics can cause damage in the esophagus if they stay there for a long time. If you have obtained antibiotics in the form of an effervescent tablet, dissolve them in a little water. Drink a large glass of water after this as well. Antibiotics in the form of drinks are often prescribed to children. Some of these drinks contain sugar, in which case make sure your child brushes his or her teeth after taking them before going to bed. 

You will reduce the risk of forgetting if you take the antibiotic at the same time every day. However, if you forgot to take your medicine on time, do so as soon as you think about it, but not if you have to take your next dose shortly afterwards. In that case, do not take the forgotten dose anymore, but take the next one at the normal time. The forgotten dose is taken at the end of the course, thus shifting the time when you finish the course. As mentioned above, it is very important that you always complete the course. It may be tempting to stop taking antibiotics if you feel better after 2 or 3 days, but this is dangerous because not all bacteria may have been killed by then. The most persistent bacteria survive and can make you sick again. In addition, they can adapt, making them possibly insensitive to this antibiotic in the future. This applies not only to yourself, but to all people who take these antibiotics. Therefore, always complete the course of treatment. 

For whom are antibiotics suitable? 

Antibiotics can be prescribed for both children and adults. It can be administered in the form of a syringe for babies and in the form of a drink for older children. 

What doses of antibiotics are there? 

Some antibiotics only need to be taken once a day, others up to 4 times a day. If you have to take the antibiotic several times a day, it is important that you take the medication evenly throughout the day, so that the amount of antibiotics in your body during the day remains the same. For example, according to the diagram below: 

  • Take once a day: every day at the same time. 
  • Take three times a day: with every meal, for example at 09.00, 13.00 and 18.00 hours. 
  • Take 4 times a day: for example at 09.00, 13.00, 18.00 and 22.00 hours. 

Please note that some antibiotics have to be taken on an empty stomach. Your doctor will tell you this and it will also be described on the label, such as: take half an hour before or two hours after a meal. With other antibiotics, it does not matter whether you take them before, during or after dinner. In this case, there is no mention of this on the label. 

What are the side effects of antibiotics? 

In general, antibiotics have few side effects, especially narrow-spectrum antibiotics. When using broad-spectrum antibiotics, side effects are more common because in this case the good bacteria in the intestines are also killed. Thin stools, however, are not always a side effect of the medicine, they can also be a side effect of the infection. 

The most common side effects of antibiotics are: 

  • diarrhoea or thin stools; 
  • hypersensitivity or allergic reaction. 

Hypersensitivity to a certain antibiotic can cause red spots on the skin, itching or fever. This may be a sign of an allergy, but is not necessarily. In this case, contact your doctor, who will determine whether this is the result of hypersensitivity of the antibiotic you are using. Antibiotics from the group of tetracyclines, such as doxycycline and minocycline, can cause hypersensitivity to sunlight. This allows you to burn faster when you are sitting in the sun, even if you normally never get sunburned. This is stated in the package leaflet. In this case, stay out of the sun as much as possible and protect your skin well with a high-protection sunscreen, even in cloudy weather. 

If you know that you are hypersensitive to an antibiotic, tell your doctor during your consultation. Even if you suffer from other symptoms that do not pass after 1 to 2 days, it is advisable to contact your doctor. 

Interaction with other medicines 

Some medications can reduce the effect of antibiotics. For this reason, it is important that you always tell your doctor clearly which other medicines you are taking. Not only medications prescribed by a specialist, but also medicines that you have bought without a prescription, such as a laxative, ibuprofen or an anti-acid agent. 

In addition, some antibiotics may reduce the reliability of the contraceptive pill. It is also possible that you will get diarrhoea from a certain antibiotic, which may also reduce the reliability of the pill. In this case, temporarily use an additional contraceptive, such as a condom. 

Use during pregnancy, while driving and with alcohol 

Some antibiotics such as penicillins are safe to use during pregnancy and lactation. But there are also antibiotics that can be harmful to your unborn child and for which the exact influence is not yet known. If you are pregnant, suspect that you are pregnant or breastfeeding, always discuss this with your doctor. Your doctor will take this into account when prescribing antibiotics. 

If you take antibiotic treatment, you can normally just drive a car. However, it is recommended that you do not drive if you experience side effects such as severe nausea or diarrhoea as this may affect your ability to concentrate while driving. The consumption of alcohol is allowed with most antibiotics. However, this does cause an extra burden on the liver because not only the antibiotic but also the alcohol has to be broken down by the liver. Therefore, drink in moderation. 

Where to buy antibiotics? 

Antibiotics are not available without a prescription. You cannot just buy these medicines on the internet or in a pharmacy. You should always make an appointment with a doctor first, then he or she will give you a prescription for antibiotics if he or she believes that your infection requires antibiotics. 

Can I get antibiotics without a prescription? 

No. 

Source: 

Drug Information Centre of the KNMP (2017). Antibiotics (online). Apotheek.nl. Available at: https://www.apotheek.nl/themas/antibiotica#uw-apotheek-en-antibiotica (Viewed on 23-11-2018). 

Ziekenhuis.nl (2018) What types of antibiotics are there? (online). Ziekenhuis.nl. Available at: https://www.ziekenhuis.nl/dossiers/werking-en-bijwerkingen-van-antibiotica-bij-bacteriele-infecties/soorten-antibiotica/item29426 (Viewed on 22-11-2018). 

KNMP (2018). Antibiotics (PDF file). Mijnapotheker.nl. Available at: https://www.mijnapotheker.nl/write/Bestanden/400003_antibiotica.pdf (Viewed on 23-11-2018). 

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