When prescribing an antibacterial medication, the doctor informs the patient that it is strictly forbidden to drink alcohol with antibiotics. Most people try to follow this recommendation, but if the course of treatment coincides with significant events or holidays, it is tempting to break the ban.
The attitude of evidence-based medicine to this situation is contradictory, as no comprehensive study has been conducted that would allow a full assessment of the negative consequences of the concomitant use of alcohol and antibacterial drugs. This does not mean that you can combine them with a calm heart, this is not recommended by any sane doctor. To understand the dangers of alcohol consumption during antibiotic therapy, the article describes the consequences of the combined effects of these substances on the body, giving examples of combinations of known drugs and alcoholic beverages.
Effects of alcohol and antibiotics on the body
Holidays in Hungary are traditionally celebrated with the consumption of alcoholic beverages. Many people can’t deny themselves this enjoyment even during illness, forgetting that alcohol in small doses has a relaxing, sedative effect, and in large doses it leads to serious health problems. Among them:
- Liver dysfunction.
- Excessive stress in the gastrointestinal tract.
- Increased heart rate.
- Death of brain cells.
- Chronic kidney and bladder diseases.
- Disorders of the nervous system.
- Severe hangover syndrome.
- Depressed state, nervous breakdown.
Consuming alcoholic beverages during an illness is definitely not worth it. In addition, it puts a strain on the body, which is already working in an emergency and struggling with the disease.
Introduced 90 years ago, antibacterial drugs quickly became a sought-after drug and saved millions of lives. The principle of the action of antibiotics is to kill the pathogenic bacteria, to destroy their structure; it blocks reproduction, prevents the growth of pathogens, after which the immune system is given the opportunity to cope with the disease on its own.
Antibacterial drugs act on a person as aggressively as possible, undermining the immune system’s ability to fight the disease on its own. Their use is mandatory in the case of a bacterial infection that the body cannot cope with alone. Only a qualified doctor is allowed to prescribe such medicines. It is categorically impossible to treat on its own, especially if the disease is of viral origin when antibacterial drugs are useless.
Antibiotics help to avoid the serious consequences of the disease, but taking them leads to a number of side effects:
- Suppression of the natural microflora of the stomach.
- Due to the suppression of immunity, the body is unable to resist the pathogens of the disease.
- The liver cannot completely cleanse the body of toxins.
The person's well-being deteriorates, lethargy, weakness occurs, depression occurs, and chronic diseases worsen.
It’s not hard to imagine what will happen to an unhappy body if we combine antibiotic treatment with violent feasts. The organs of the immune system, kidneys, liver and gastrointestinal tract receive a double load that is extremely difficult to cope with. This can lead to a worsening of the current condition and from the acute phase the disease becomes chronic, which is much more difficult to treat.
The effect of alcohol on antibacterial drugs
Evidence-based medicine has no specific example of the weakening effect of antibiotics in the background of alcohol consumption. Sometimes the opposite happens: the number of enzymes increases and the drug breaks down faster. But another scenario is possible when the drug is poorly excreted from the body, accumulates in the cells, and results in an undesirable reaction.
Two strange theories explain why the incompatibility of antibiotics and alcohol can be considered a scientific fact. According to the first, antibacterial drugs were originally used to treat sexually transmitted infections. Doctors saw the presence of such diseases as a sign of immoderation and character weakness, and a ban on alcohol consumption became a form of punishment.
The second theory emerged during World War II, when wounded soldiers needed penicillin. There were so few drugs that legend has it that doctors tried to extract them from the urine. The problem was that soldiers in their spare time liked to drink beer, which has a diuretic effect and reduces the concentration of microorganisms. Therefore, alcoholic beverages have been banned and the postulate that alcohol and antibiotics are incompatible has been gradually incorporated into medicine.
There are several reasons for this statement. Doctors note that patients who drank alcohol at the same time as antibacterial drugs had a much slower recovery than those who lived a sober lifestyle. The reason is that the intake of alcohol with antibiotics is fraught with other negative consequences of deteriorating the immune system. With regular consumption of alcoholic beverages, it is impossible to create a proper daily diet with proper rest and diet. However, vitamins, minerals and nutrients cannot be completely absorbed and the body is gradually depleted. As a result, the patient's medication will be ineffective.
Compatibility of alcoholic beverages and antibiotics
Modern antibiotics are gentle. Their combination with alcohol in most cases does not have strong negative consequences for the body. Doctors identify a number of medications that cannot be combined with strong drinks. The rate of their assimilation is related to the work of the same enzymes that are responsible for breaking down ethanol - the basis of alcoholic beverages. Enzymes cannot cope with a huge amount of work and as a result, the drug accumulates in the body. This has side effects that one will soon feel private.
The interaction of antibiotics and alcohol leads to a large list of negative consequences:
- Severe migraine-like headache.
- Nausea, vomiting.
- Dizziness, loss of consciousness.
- Fast heartbeat, arrhythmia.
- Fever, elevated temperature.
- Heavy sweating.
- Insomnia.
- A condition close to depression and irritability.
- Weakness, drowsiness, loss of strength.
- Inflammatory processes of the liver, jaundice.
- Gastric pain due to gastritis and ulcers.
Disulfiram-like reaction
The most common and most dangerous negative consequence is a disulfiram-like reaction. This drug used to treat alcohol dependence can affect the work of enzymes that process ethyl alcohol. Metabolism consists of two stages:
- Ethyl alcohol decomposes to acetaldehyde.
- The acetic aldehyde is converted to acetic acid.
Incompleteness of the second stage leads to the strongest hangover syndrome. For lovers of alcoholic beverages who take the drug, the process of timely distribution of ethanol is interrupted, and if a dose of alcohol is added in the background of intake, the body overflows with toxic substances. Drinking alcohol while intoxicated is not possible and the patient gets rid of the addiction.
Signs of a disulfiram-like reaction are similar to those of a severe hangover:
- Chills.
- Increased heart rate.
- Nausea, vomiting.
- Cramps.
- Allergic reactions.
- Headache.
- Respiratory failure.
The latter manifestation of a disulfiram-like reaction is life-threatening due to the likelihood of death. When mixing antibiotics and alcoholic beverages, the patient should be careful and closely monitor for changes in their condition. The consequences can appear during or 4-5 hours after a feast. In this situation, you should seek medical help immediately.
Effects of concomitant use of antibiotics and alcohol on liver and gastrointestinal tract function
The main reason for the ban on the combined intake of antibiotics and alcohol is the risk of toxic liver damage. Its enzymes are unable to assimilate drug and ethanol simultaneously. In this fight, alcohol usually wins and the drug accumulates in the liver cells, threatening severe poisoning.
During illness, the liver is involved in cleansing the body of toxins and toxins, and alcohol increases the load many times over. People who are used to mixing medications and spirits are more likely to develop fibrotic tissue changes and liver failure.
Alcohol consumption during antibiotic therapy can have a detrimental effect on the gastrointestinal tract. When ethyl enters the stomach, it causes congestion and vasodilation, which facilitates the absorption of alcohol. If an antibacterial drug enters the gastrointestinal tract after a short time, the drug is not completely absorbed and the effect of the treatment is reduced to zero.
Antibiotics can negatively affect the gut microflora. Patients taking these medications often complain of abdominal pain, stool problems, constipation, or diarrhea. Prebiotics and probiotics are often prescribed after antibiotic treatment to restore the balance of the microflora. If you drink alcohol at this time, it can cause chronic gastrointestinal diseases such as gastritis or gastric ulcer.
Possibility of an allergic reaction
In addition to ethyl alcohol, the composition of alcoholic beverages also contains additives, colorants, flavors and preservatives. The end result of their interaction with antibiotics is unpredictable. A potential hazard is a mild or severe form of allergic reaction. At best, itching, redness, sneezing, at worst shortness of breath, Quincke's edema and death. If someone notices such symptoms, take an antihistamine urgently, and if they have serious consequences, call an ambulance immediately.
Before taking the medication, patients should read the instructions carefully and check how safe the combination of the active substances and ethanol is.
The combination of alcohol with groups of known antibacterial drugs
A disulfiram-like reaction is life-threatening. Based on the studies conducted, scientists have figured out which drugs are more likely to cause it and which can be considered relatively safe in combination with alcohol.
Alcohol and nitroimidazoles
Nitroimidazoles are considered broad-spectrum antibiotics and are used to treat the following conditions:
- central nervous system infections (meningitis, cerebral abscess);
- intestinal infections;
- respiratory diseases (pneumonia, abscess);
- oral infections;
- skin diseases of various etymologies;
- prevention of infections during surgery.
Medicines in this group should not be combined with alcohol! Although not everything is that simple. Studies in 2003 did not reveal any negative effects of concentrated beverages during drug use. However, physicians are confident that the combination of these could have the following consequences:
- sharp pain in the abdomen;
- nausea, vomiting;
- severe headache;
- chills;
- violation of heart rhythm;
- in rare severe cases, respiratory failure develops.
Women should be aware that a disulfiram-like reaction is possible not only with oral administration and injection, but also with the use of a vaginal cream.
Alcohol and cephalosporins
Cephalosporins are a broad-spectrum group of drugs with strong bactericidal activity. They are considered to be the main "destroyers" of streptococci and staphylococci and treat the following diseases:
- upper respiratory tract infections;
- diseases of the nose, throat, ears;
- infections of the skin, soft tissues.
Cephalosporins are often prescribed for purulent sore throats - this is one of the most common infections in Hungary.
All cephalosporins, like nitroimidazoles, are capable of eliciting a disulfiram-like reaction. Main symptoms: nausea, headache, abdominal pain, caused by intoxication of the body. The possibility of a disulfiram-like reaction should be taken seriously because the consequences can be severe and even fatal.
There are drugs that do not fall into the two groups listed above, i. e. their interaction with alcohol does not lead to a disulfiram-like reaction but also has negative consequences.
Antibiotics that make alcohol consumption relatively safe
Many antibacterial drugs have been successfully tested for alcohol compatibility and their combination is safe for the body.
- Penicillin antibiotics.
- Expectorants and mucus removers prescribed for lung diseases to thin out viscous secretions.
- Antifungal agents.
The above medications can be taken with alcohol, but that doesn’t mean they can be washed off with strong drinks! The best way to develop events while taking antibiotics is to completely refuse to consume alcohol.
How to properly combine alcohol and antibiotics - safety precautions
The best way to get things done while treating a patient with antibiotics is to refuse alcohol while taking the medication. In exceptional cases, when you cannot do without drinking, the following safety rules must be observed:
- Ask your doctor if you should mix alcohol with medication and consider giving up strong drinks.
- The minimum time between taking an antibiotic and drinking alcohol is 4 hours. A shorter period is associated with major health problems.
- The amount consumed depends on gender, weight, the severity of the current disease, the strength of the drink and should not exceed 300-350 ml.
- Ethanol is found not only in strong beverages (vodka, cognac, whiskey) but also in low-alcohol beverages (wine, champagne, beer). Even if the alcohol content is multiple here, drinking will not go unhealthy.
In patients on antibiotic treatment, the question arises: for how long after the course should I drink alcohol? The exact answer can be given by your doctor, and it depends on several factors: gender, age, the nature of your illness, your state of health, and your medication. Most drugs have a cumulative effect and continue to affect the body after it is stopped. Doctors recommend that you start drinking alcohol no earlier than 5 days after stopping treatment.
There are three rules when taking antibacterial drugs:
- Antibacterial drugs are prepared and prescribed in various dosage forms: tablets, syrups, intravenous and intramuscular injections, eye drops, ointments, suppositories, inhalation solutions. Any form of the medicine can cause side effects.
- Ethanol in alcoholic beverages is harmful to human health. It is present not only in cognac, wine and beer, but also in cough syrups, herbal tinctures (licorice, marshmallows, echinacea, eleutherococcus). The composition of drugs taken concomitantly with antibiotics should be investigated.
- Read the instructions for the medicine carefully to find out how compatible it is with alcohol. If the instructions say that no research has been done on this issue or there is no information, you should stop consuming alcoholic beverages during treatment.
Antibacterial drugs impose an unnecessary burden on the body and are prescribed for serious illnesses. The doctor can only prescribe a certain medication, everything else depends on the patient, who must first of all think about healing as soon as possible. The sick person should take the prescribed medications on time, sleep at least 7-8 hours a day, and eat foods high in vitamins and trace elements. It is better to forget about alcohol during this period. This is especially true for people with chronic heart, liver and kidney disease. Otherwise, the negative consequences will not force themselves to harvest. May:
- Central nervous system failure and the gradual destruction of brain cells.
- Poisoning of the body with symptoms of diarrhea, nausea, vomiting.
- Kidney damage, urinary problems.
- Violation of heart rhythm.
- Gastritis, gastric ulcer.
- Violation of the intestinal microflora.
- Damage to the liver leading to gradual cell death.
- Decreased immunity, the body will not be able to cope with infections on its own.
- Cardiopalmus.
- An increase in blood pressure is dangerous in hypertensive patients.
- Stool disorders in the form of constipation or diarrhea.
- Weakness, drowsiness, loss of strength.
- Depressed state, nervous breakdown.
- Irritability, insomnia.
- Decreased intellectual abilities, impaired memory, concentration of attention.
- Fever and chills.
- Severe headache.
- Cramps.
- Allergic reactions in the form of itching, rash and redness.
- Dyspnoea and Quincke's edema - death without timely medical attention.
- The effect of treatment is minimal or absent.
- The disease can become chronic, which reduces the patient's quality of life.
Alcohol in small doses complements the holiday and helps to relax. But using it during illness does not cause joy and can harm the body. This is the most important thing one needs to remember when deciding whether it is worth mixing alcohol and antibiotics.