General antibiotics (drug interactions)
General antibiotics are substances produced by microorganisms that inhibit the growth of harmful bacteria. While effective in treating infections, antibiotics can interact with various substances, leading to potential complications. Notably, the use of probiotics, like Lactobacillus acidophilus and Bifidobacterium longum, may help mitigate antibiotic-associated diarrhea, a common side effect caused by the disruption of beneficial gut bacteria.
Additionally, antibiotics can affect vitamin K levels, which is particularly significant for individuals with existing deficiencies or those taking anticoagulants like Warfarin, as this could enhance the anticoagulant's effects. Patients on birth control pills are advised to utilize backup contraception, as certain antibiotics may reduce the efficacy of these medications. Furthermore, interactions can occur with anticoagulants, anticonvulsants, and diabetic medications, making it crucial for patients to disclose all medications and supplements to their healthcare providers. Grapefruit and certain antacids should also be avoided due to their potential to interfere with antibiotic absorption. Overall, understanding these interactions is vital for safe and effective antibiotic use.
Subject Terms
General antibiotics (drug interactions)
DEFINITION: Substances produced naturally by microorganisms that inhibit the growth of other microorganisms, especially harmful bacteria.
INTERACTIONS: Acidophilus, Bifidobacterium longum, Lactobacillus acidophilus, probiotics, vitamin K, grapefruit, many medications
DRUGS IN THIS FAMILY: Amoxicillin (Amoxil, Amoxicot, Trimox, Wymox, Moxilin, Sumox), amoxicillin/potassium clavulanate (Augmentin), ampicillin (Omnipen, Principen, Totacillin, Marcillin), azithromycin (AzaSite, Zmax, Zithromax), bacampicillin (Spectrobid), carbenicillin indanyl sodium (Geocillin), chloramphenicol (Chloromycetin Kapseals), cinoxacin (Cinobac), clarithromycin (Biaxin, Klaricid, Voquezna), clindamycin (Cleocin), cloxacillin sodium (Cloxapen, Tegopen, Bactopen), colistin sulfate (Coly-Mycin S), dapsone, dicloxacillin sodium (Dycill, Dynapen, Pathocil), dirithromycin (Dynabac), erythromycin (E-Base, Ilosone, EryPed, E. E. S., Ery-Tab, E-Mycin, Eryc, Erythrocin, PCE), fosfomycin tromethamine (Monurol), kanamycin (Kantrex), lincomycin (Lincocin), metronidazole (Flagyl, Acea, Rozex), nafcillin sodium (Nallpen, Unipen), nalidixic acid (NegGram, Nevigramon, Wintomylon), neomycin (Neo-Tab, Mycifradin, Neo-Fradin), novobiocin (Albamycin, Panalba), oxacillin sodium (Bactocill, Prostaphlin), paromomycin (Humatin), penicillin V (Pen Vee K Beepen-VK, Penicillin VK, Veetids), vancomycin (Vancocin)
Vitamin K
Effect: Possible Nutritional Depletion
Vitamin K is crucial in blood clotting and is important for proper bone formation. There are concerns, however, that antibiotic treatment might reduce vitamin K levels in the body because antibiotics destroy vitamin K-producing gut bacteria. Cephalosporin antibiotics are most commonly linked to this problem because they destroy gut bacteria and inhibit vitamin K’s ability to function in the body. However, this effect is relatively slight and usually only medically significant in individuals with a preexisting vitamin K deficiency, older adults, malnourished individuals, or those individuals taking the oral anticoagulant medication Warfarin, which increases in potency when taken with antibiotics.
Acidophilus and Other Probiotics
Effect: Probable Helpful Interactions
One common side effect of antibiotic therapy is antibiotic-associated diarrhea (AAD), which occurs in between 5 and 30 percent of individuals taking antibiotics. AAD is primarily caused by antibiotics, which kill many of the “friendly” bacteria that normally live in the intestines. Some patients taking specific antibiotics contract a Clostridioides difficile infection, which causes life-threatening diarrhea. Changes in bacteria can also cause yeast infections. However, using helpful microorganisms (probiotics) such as Saccharomyces boulardii, L. acidophilus, or Bifidobacterium longum at the same time one starts antibiotics, and if continuing antibiotics for some time afterward may reduce the risk of these complications.
Several other drug interactions may occur when a patient takes a course of antibiotics. Women who take birth control pills should use a backup method of contraception while taking antibiotics as they may make the birth control pills less effective. Antibiotics can also have adverse reactions when combined with anticoagulants, anticonvulsants, and diabetic drugs. Different antibiotics react differently to different medications, so it is important for patients to tell their doctors about all medications and supplements they are taking.
Grapefruit should also be avoided while taking antibiotics as it blocks the action of enzymes that break down antibiotics in the body. Antacids may slow the body's absorbtion of tetracyclines and clindamycin antibiotics and the active ingredient in Pepto-Bismol, bismuth subsalicylate, can limit doxycycline absorbtion. Finally, alcohol should be avoided when taking antibiotics.
Bibliography
“Antibiotic-Associated Diarrhea - Symptoms & Causes.” Mayo Clinic, 2023, www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231. Accessed 16 Sept. 2024.
“Antibiotics - Interactions.” NHS, 11 Nov. 2022, www.nhs.uk/conditions/antibiotics/interactions. Accessed 16 Sept. 2024.
"Antibiotic Medications and Alcohol Interactions." Drugs.com, 30 May 2024, www.drugs.com/article/antibiotics-alcohol.html. Accessed 16 Sept. 2024.
Beniwal, R. S., et al. “A Randomized Trial of Yogurt for Prevention of Antibiotic-Associated Diarrhea.” Digestive Diseases and Sciences, vol. 48, 2003, pp. 2077-82.
Correa, N. B., et al. “A Randomized Formula Controlled Trial of Bifidobacterium lactis and Streptococcus thermophilus for Prevention of Antibiotic-Associated Diarrhea in Infants.” Journal of Clinical Gastroenterology, vol. 39, 2005, pp. 385-89, doi:10.1023/a:1026155328638.
Kujawa-Szewieczek, Agata, et al. “The Effect of Lactobacillus plantarum 299v on the Incidence of Clostridium Difficile Infection in High Risk Patients Treated with Antibiotics.” Nutrients, vol. 7, no. 12, 2015, pp. 10179-88, doi:10.3390/nu7125526.
Preston, Claire L. Stockley’s Drug Interactions. 12th ed., Pharmaceutical Press, 2021.
Szajewska, H., and M. Kołodziej. “Systematic Review with Meta-Analysis: Saccharomyces Boulardii in the Prevention of Antibiotic-Associated Diarrhoea.” Alimentary Pharmacology & Therapeutics, vol. 42, no. 7, 2015, pp. 793-801, doi:10.1111/apt.13344.