Medicine / Emergency
ATTN: Medical Professionals - Want to get published and be heard on nyjsm.com?
Click Here to Submit your Educational Article or Professional Medical Opinion

Advertisement:

Kaplan Test Prep and Admissions (Kaptest.com)


Alcohol and Antibiotics

December 26, 2017

Hunter S. Clonts - Medical Student1, Matthew Vasey MD2


1MD Candidate, Florida International University Herbert Wertheim College of Medicine, Class of 2020
2Department of Emergency Medicine, Tampa General Hospital | TeamHealth, an affiliate of University of South Florida Morsani College of Medicine

Disclosure: Opinions reflect neither employer nor affiliated institutions, soley those of the author(s).


In 2015, the National Institute of Health revealed that nearly 42 percent of US adults who drink also report using some form of prescription medication known to interact with alcohol. (1) Whether prescribed for a sore throat, ear infection, STD, or simply as empiric treatment to treat a potential infection, antibiotics are one of the most prescribed forms of medications to young adults today. A trending google search among these young adults trying to maintain their social life during their antibiotic course is thus "can I drink alcohol while taking my antibiotics?"

While many medications can interact with alcohol, the answer to the above search is not so clear-cut. In short, it depends on which type of antibiotic the patient in question is taking as well as the patient's age. For the sake of this article, we will be discussing antibiotic-alcohol interactions in an otherwise healthy young adult.

Patients often assume that they should avoid alcohol while taking any antibiotics; however, this belief has no foundation with all antibiotics. (2) In fact, only a relatively small number of antibiotics appear to interact with alcohol when consumed together. The antibiotic erythromycin may increase alcohol absorption in the intestine as it increases stomach emptying. (5) Another study also found that people taking the antituberculosis drug isoniazid should avoid concurrent alcohol use as the interaction can cause liver damage. (5) Perhaps the most common interaction between alcohol and antibiotics is known as the "disulfiram-like reaction," named after the medication "disulfiram" which is a drug prescribed to alcoholics to essentially give them instant hangover symptoms. The disulfiram-like reaction can consist of flushing, nausea, abdominal cramps, headache, low blood pressure and even heart palpitations - a list of antibiotics known to cause a disulfiram-like reaction when combined with alcohol are listed in the table below. (1)


To conclude, most antibiotics prescribed in general practice do not require abstinence from alcohol. (4) Aside from isoniazid and the antibiotics known to cause a disulfiram-like reaction, evidence shows that moderate alcohol consumption probably does not interfere with antibiotic effectiveness or metabolism. (5) There are, however, concerns regarding concurrent alcohol use with any form of underlying infection in the body as research findings have indicated that heavy alcohol use can impair the function of certain immune cells needed to fight those infections. (5) That being said, even in the setting of no alcohol-antibiotic interaction, it is likely best to avoid heavy alcohol use while the body mounts its defense against any invading organism that might be causing infection. Despite the seemingly ubiquitous benign presence of alcohol in college, there remains potential for long-term negative bio-psycho-social effects which should prompt in the least a reasonable level of discretion when engaging in otherwise accepted mainstream collegiate social practice.



REFERENCES:

1. Harkness R. Antibiotics and alcohol: A dangerous duo. Prevention [serial online]. 2009:Available from: Student Resources in Context, Ipswich, MA. Accessed November 26, 2017.
2. J. L, J. S. B, C. S. B. Do Antibiotics and Alcohol Mix?. BMJ: British Medical Journal [serial online]. 2008;(7684):1466. Available from: JSTOR Journals, Ipswich, MA. Accessed November 26, 2017.
3. NIH study reveals many Americans at risk for alcohol-medication interactions. National Institutes of Health: News and Events [serial online]. 2015:Available from: Academic OneFile, Ipswich, MA. Accessed November 26, 2017.
4. Vernon G. Sex, drugs and alcohol. Australian Prescriber [serial online]. April 2013;36(2):46-48. Available from: Academic Search Complete, Ipswich, MA. Accessed November 26, 2017.
5. Weathermon R, Crabb D. Alcohol and Medication Interactions. Alcohol Research & Health [serial online]. 1999;(1)Available from: Academic OneFile, Ipswich, MA. Accessed November 26, 2017.




ATTN: Medical Professionals - Want to get published and be heard on nyjsm.com?
Click Here to Submit your Educational Article or Professional Medical Opinion
NYJSM.com on Social Media