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Don’t Put Your Antibiotics at Risk

Ruth Kim, Pharm.D. Candidate 2011

Consumer Health Information Corporation and

Howard University School of Pharmacy

and

Dorothy L. Smith, Pharm.D.

CEO and President

Consumer Health Information Corporation

McLean, Virginia

 

 Antibiotics are very helpful medicines in killing bacteria. When you do not take an antibiotic the right way, you could get antibiotic resistance. It could be very difficult for your doctors to treat your infection in the future.  

Antibiotic resistance happens when bacteria do not die from the medicine. This takes place when there is not enough medicine in your body. Some common reasons are:

  • You did not take it at the right time.
  • You stopped the medicine too soon.
  • You took it with food when the medicine should be taken on an empty stomach.

When there are not enough antibiotics in your body to fight the bacteria, the strong ones live on to multiply. Now these bacteria are not killed by antibiotic.

 The only choice your doctor has is to use a stronger antibiotic to kill the bacteria. These stronger antibiotics can have more serious side effects.  

 

How Can I Avoid “Antibiotic Resistance”?

You should first take antibiotics as prescribed. Every antibiotic has special instructions that you need to know. Here are some tips on how to take some of the most common antibiotics.  

  • Take the full dose of your prescription medicine

Some antibiotics need to be in your body for a set amount of time to work. This is why you must take these antibiotics exactly as prescribed.  

If the directions say to take your antibiotics for 10 days, you must take all the medicine. Do not stop the medicine early simply because you feel better. You will be giving strong bacteria the chance to multiply if you stop the antibiotics too soon. 

  • Follow exact instructions for use

Some antibiotics need an exact amount of medicine in your body to do the job. Help antibiotics work for you by always finishing your antibiotic.  For example, if the prescription is written:

    • “Take one (1) capsule every 6 hours”: You could take the medicine at 6AM, noon, 6PM and midnight.
    • “Take two (2) tablets every 12 hours”: You could take two tablets in the morning and the next two 12 hours later.

If you do not take the antibiotics at the right time you are at risk of getting antibiotic resistance. 

 

How Should I Take My Antibiotics?

  • Take some antibiotics with water

Antibiotics that should be taken with a full glass (8 ounces) of water: (not a complete list)

  • Ciprofloxacin (Cipro®)Levofloxacin (Levaquin®)
  • Doxycycline (Doryx®, Periostat®, Vibramycin®)  Especially with doxycycline hyclate (Doryx®). Drink a FULL glass of water to avoid stomach irritation.9
  • Tetracycline (Tetracyclin®, Sumycin®)

DO NOT take the above medicines with some drinks containing calcium or iron. These can make your medicine less effective.

    • Herbal teas
    • Popular flavored water
    • Smoothies
    • Orange juice
    • Grapefruit juice
    • Milk
    • Milk of magnesia

     

  • Avoid taking some antibiotics with vitamins, minerals, and herbal products

Some antibiotics must not be taken at the same time as your vitamins, minerals and herbal products. For example:

    • Iron or calcium or magnesium Antacids containing calcium or magnesium
    • Milk of magnesia

The antibiotics could be less effective if you do not space them apart.  

Table 1: Medicines to avoid with vitamins, minerals and herbal products.

Generic Name

Brand Name

Suggestions

Ciprofloxacin

Cipro®

Take two hours before and after taking the vitamins, minerals, and herbals.

Doxycycline

Doryx®, Periostat®, Vibramycin®

Levofloxacin

Levaquin®

Tetracycline

Tetracyclin®, Sumycin®

Take four hours before and after taking the vitamins, minerals, and herbals, especially those containing calcium.

 

  • Do NOT take some antibiotics with food

Some antibiotics should not be taken with food. The table below shows the length of time to separate your antibiotics from food. Food may decrease the amount of antibiotic in your body when you take them too close to your meals. This makes the antibiotic less effective. This can also place you at risk of antibiotic resistance.

Table 2: Antibiotics that should NOT be taken with food.

Generic Name

Brand Name

Suggestions

Ampicillin

Principen®

Take two hours before and four hours after food.

Ciprofloxacin

Cipro®

Doxycycline

Doryx®, Periostat®, Vibramycin®

Take two hours before and four hours after food. If you notice stomach upset, take doxycycline one hour after a food.

Metronidazole ER

Flagyl ER®

Take two hours before and four hours after food.

Tetracycline

Tetracyclin®, Sumycin®

 

  • Take some antibiotics with food

These antibiotics work best when they are taken with food. Food makes it easier for your body to absorb these antibiotics. 

Table 3: Antibiotics that should be taken with food.

Generic Name

Brand Name

Suggestions

Amoxicillin Clavulanate

Augmentin®

Take with food

Metronidazole

Flagyl®

Nitrofurantoin

Microbid®, Microdantin®

 

  • Take some antibiotics either with or not with food

The antibiotics listed below can be taken with food or not with food. The acid in your stomach does not change how well the medicine is absorbed into your body. 

Table 4: Antibiotics that can be taken regardless of food.

Generic Name

Brand Name

Suggestions

Azithromycin

Z-Pak®, Zithromax®

Take with or without food

Cefuroxime

Ceftin®, Zinacef®

Erythromycin

Eryc®

Levofloxacin

Levaquin®

 

Take charge of your health. Do not put your antibiotics at risk of antibiotic resistance. Follow these simple rules to take antibiotics safely and effectively. Not every antibiotic works the same way. Talk with your doctor and pharmacist if you have any questions about how to take your medicine.


 

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