Can you drink alcohol on antibiotics? Antibiotic do’s and don’ts

Most of the time you visit the doctor, it’s because you’re sick or not feeling well. Maybe you’re scheduling a visit, hoping your doctor will have some medicine—like an antibiotic—to improve your symptoms or make you feel better sooner.

This is one of the more misunderstood topics of medicine. Let’s dive into the topic of antibiotics, how they work, when they’re useful and some antibiotic do’s and don’ts.

What are antibiotics used for?

Antibiotics, first used in the late 1930s, changed the scope of modern medicine. Antibiotics specifically target and fight bacterial infections. Some common bacterial infections include:

• Sinusitis
• Streptococcal pharyngitis (strep throat)
• Otitis media (ear infection)
• Pneumonia
• Urinary tract infection (UTI)

What are antibiotics not used for?

It’s easy to confuse bacterial infections with viral infections. Viral infections are extremely common, very contagious and cause symptoms of the common cold: sore throat, fatigue, body aches, cough, fever, loss of voice, diarrhea and nausea.

The good part about viral infections is that your immune system is very well equipped to fight it off. The bad part about a viral infection is that you need to give your body time. There is no “quick fix.” A viral infection typically lasts 7-14 days.

There are medicines to improve your symptoms, but overall, there is nothing to “cure the infection” besides time and allowing your immune system to fight the infection. Antibiotics are not effective against viral infections. This is a common misunderstanding.

How do antibiotics work?

Antibiotics specifically target bacterial infections and have various mechanisms of action. Antibiotics can be bactericidal (kill the bacteria) or bacteriostatic (stop the bacteria from multiplying and the bacteria remain in a stationary phase). This works with the body’s natural immune system to fight the infection. 

Antibiotics can attack the wall or coating surrounding bacteria, interfere with bacterial reproduction or block protein production in bacteria. Each antibiotic works on specific bacteria. 

There are certain antibiotics chosen for a specific infection depending on the common organisms that typically cause an infection. That’s why it is extremely important that you visit your doctor prior to starting an antibiotic or “borrowing” a friend or family member’s medicine. The antibiotic will come with instructions on how long and how many times per day to take the medicine. 

How long is it safe to take antibiotics?

It is recommended you take antibiotics for the least amount of time necessary to resolve the infection. Long-term or daily antibiotics are typically not recommended. The longer you take an antibiotic, the more likely you can become resistant to antibiotics. If you are resistant, the bacteria have mutated, and the antibiotic is no longer able to cure the infection.

There are specific medical conditions that require long-term antibiotics. This should always be discussed with your primary care physician, who is aware of your medical conditions and history, to determine the length of time necessary to take antibiotics for your specific condition. 

Can you drink on antibiotics?

For the most part, alcohol in moderation (one drink for women, two drinks for men) is fine when taking antibiotics. However, certain antibiotics do require you to refrain from drinking while taking them so you should always discuss this with your prescribing physician.

At the same time, alcohol impairs healing and lowers your immune system. If your body is currently fighting an infection, it is best to abstain from alcohol to allow your body to heal and your immune system to be fully functional. 

Can you take antibiotics while pregnant?

You can safely take antibiotics while pregnant or breastfeeding. It’s important to understand that pregnancy lowers your ability to fight off infections. During pregnancy, your body is under extreme stress. You are immunocompromised, meaning you are more likely to develop an infection than someone who is not pregnant.

Antibiotics can be safely used during pregnancy and do not pose a risk to you or your developing baby. Keep in mind that while breastfeeding, anything you consume will pass at some level into the breast milk, and this includes medication.

Always discuss with your doctor if you are pregnant or breastfeeding prior to starting any new medicine. There are some drugs which are contraindicated, meaning they are not recommended during pregnancy or breastfeeding.  

Can antibiotics cause diarrhea and other side effects?

Common side effects of antibiotics include: 

• Diarrhea 
• Nausea 
• Vomiting 
• Abdominal cramping 

A side effect is different from an allergic reaction such as anaphylaxis, which is life-threatening. If you experience throat closing, shortness of breath or trouble breathing, call 911 or proceed to the nearest ER. 

Should you take a probiotic while taking antibiotics?

Let’s talk about gut bacteria for a minute. Our gut is made up of trillions of bacteria, parasites and fungi—this is known as your microbiome. Your microbiome serves to strengthen your immune system. 

Antibiotics are like a nuclear bomb for your microbiota. Antibiotics can lead to dysbiosis (an imbalance in the gut microorganisms). This can lead to side effects such as diarrhea, abdominal cramping, constipation, nausea, yeast infections and many others.

This is where a probiotic can be very beneficial while taking an antibiotic. Probiotics are formulated to restore your beneficial bacteria or gut health. A probiotic can potentially decrease the likelihood or decrease the risk of some side effects.

You can take a probiotic supplement or incorporate probiotic foods like yogurt and kefir that can improve your gut health as well. Here are a few other tips for staying healthy while taking an antibiotic:

• Get regular exercise
• Eat a diet full of fruits and vegetables
• Prioritize healthy sleep
• Get adequate vitamin C

The do’s and don’ts of taking antibiotics

• Do take the full length of time an antibiotic is prescribed. This can lower the risk of antibiotic resistance. 
• Do follow the recommendations. Take one time per day if recommended, or take four times per day if recommended. This can be tricky to remember, so you may need to set reminders. If you take less than the number of times recommended, you risk allowing the bacteria to mutate and become resistant.
• Don’t take antibiotics if not specifically prescribed to you for a specific diagnosis. Many times, it seems difficult to get in to see a physician. You may have symptoms of a urinary tract infection, your mom or sister recently had the same condition, and the antibiotic is ready and available. The danger arises if you have similar symptoms but a different diagnosis. That antibiotic may not be effective for you. If there are only a few pills left, you may not fully treat the infection, which can lead to antibiotic resistance.
• Don’t overdo it on alcohol. Remember, some antibiotics require you to refrain from alcohol, so be sure and talk to your physician.
• Don’t share medications with others. 

Antibiotics can be extremely helpful for getting rid of bacterial infections and helping you feel better faster. Be sure and talk to your prescribing physician about any questions related to your particular health condition or the antibiotic you’ve been prescribed.

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