After effects of antibiotics symptoms: Antibiotics – Side effects – NHS
Antibiotics – Side effects – NHS
The most common side effects of antibiotics affect the digestive system. These happen in around 1 in 10 people.
Side effects of antibiotics that affect the digestive system include:
- nausea (feeling like you may vomit)
- bloating and indigestion
- abdominal pain
- loss of appetite
These side effects are usually mild and should pass once you finish your course of treatment.
If you get any additional side effects, contact your GP or the doctor in charge of your care for advice.
Antibiotic allergic reactions
Around 1 in 15 people have an allergic reaction to antibiotics, especially penicillin and cephalosporins. In most cases, the allergic reaction is mild to moderate and can take the form of:
- a raised, itchy skin rash (urticaria, or hives)
- tightness of the throat, which can cause breathing difficulties
These mild to moderate allergic reactions can usually be successfully treated by taking antihistamines.
But if you’re concerned, or your symptoms don’t get better with treatment, call your GP for advice. If you cannot contact your GP, call NHS 111.
In rare cases, an antibiotic can cause a severe and potentially life-threatening allergic reaction known as anaphylaxis.
Initial symptoms of anaphylaxis are often the same as a mild allergic reaction. They include:
- feeling lightheaded or faint
- breathing difficulties – such as fast, shallow breathing
- a fast heartbeat
- clammy skin
- confusion and anxiety
- collapsing or losing consciousness
There may be other allergy symptoms, including an itchy, raised rash (hives), feeling or being sick, swelling (angioedema), or stomach pain.
Anaphylaxis is a medical emergency and can be life-threatening. Dial 999 immediately and ask for an ambulance if you think you or someone around you is experiencing anaphylaxis.
Tetracyclines and sensitivity to light
Tetracyclines can make your skin sensitive to sunlight and artificial sources of light, such as sun lamps and sunbeds.
Avoid prolonged exposure to bright light while taking these medicines.
Severe aches and pains
In very rare cases, fluoroquinolone antibiotics can cause disabling, long-lasting or permanent side effects affecting the joints, muscles and nervous system.
Stop taking fluoroquinolone treatment straight away and see your GP if you get a serious side effect including:
- tendon, muscle or joint pain – usually in the knee, elbow or shoulder
- tingling, numbness or pins and needles
Fluoroquinolone antibiotics can cause serious side effects in people who are at risk of heart valve problems.
Stop taking fluoroquinolone treatment straight away and see your GP if you get a serious side effect including:
- swollen ankles, feet and legs (oedema)
- new heart palpitations (heartbeats that suddenly become more noticeable)
- sudden shortness of breath
Reporting side effects
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you are taking.
It’s run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).
Page last reviewed: 23 May 2019
Next review due: 23 May 2022
Side Effects, What Is It & Usage
What are antibiotics and how are they used?
Antibiotics are powerful drugs that are used to fight infections. Your healthcare team thinks you or your loved one might have an infection that can be treated with an antibiotic.
Not all infections are treated with antibiotics. While antibiotics may be effective against infections caused by bacteria (germs), they are not effective against viruses.
Like all drugs, antibiotics can have side effects and should be used only when necessary. Taking an antibiotic you don’t need can even be harmful. Because of this, there are important things to know about antibiotics.
What do I need to know about antibiotics?
Did you know:
- Antibiotics are among the most commonly prescribed drugs. However, up to 50% of all the antibiotics prescribed for people are not needed nor as effective as hoped.
- The overuse of antibiotics is the single most important factor that has led to antibiotic resistance.
- Each year in the United States, at least 2 million people get serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections.
- At least 23,000 people die each year as a direct result of these antibiotic-resistant infections. Almost 250,000 people each year need hospital care for treatment of Clostridium difficile (C. difficile) infections. This infection is very difficult to treat. The use of antibiotics was the main reason why the illness developed. At least 14,000 people die each year in the United States from C. difficile infections. Many of these infections could have been prevented.
The overuse or inappropriate use of antibiotics gives bacteria a chance to adapt. When this happens, the antibiotics no longer work as well to treat the infection – the bacteria become “resistant” to antibiotics.
What should I know about antibiotic safety?
Antibiotics are powerful drugs that are generally safe. They are very helpful in fighting disease, but sometimes antibiotics can actually be harmful.
Key facts to know about antibiotic safety:
- Antibiotics can have side effects including allergic reactions and serious, possibly life-threatening diarrhea caused by the bacteria (germ) Clostridium difficile (C. diff). Antibiotics may also interfere with other drugs you may be taking.
- Side effects of antibiotics are responsible for almost one out of five emergency department visits. They are the most common cause of emergency department visits for children under 18 years of age.
- When you take an antibiotic you do not need, you are unnecessarily exposed to the side effects of the drug and do not get any benefit from it.
Taking an antibiotic you don’t need can lead to the development of antibiotic resistance. When resistance develops, antibiotics may not be able to stop future infections. Every time you take an antibiotic you don’t need, you increase your risk of developing a resistant infection in the future.
The bottom line: antibiotics come with benefits and risks. If you are prescribed an antibiotic, discuss the balance of benefits and risks with your healthcare team.
What side effects are related to antibiotics?
- Allergic reactions: Every year, there are more than 140,000 emergency department visits for reactions to antibiotics. Almost four out of five emergency department visits for antibiotic-related side effects are due to an allergic reaction. These reactions can range from mild rashes and itching to serious blistering skin reactions, swelling of the face and throat, and breathing problems. Minimizing unnecessary antibiotic use is the best way to reduce the risk of side effects from antibiotics. You should tell your doctor about any past drug reactions or allergies.
- C. difficile: C. difficile is a type of bacteria (germ) that causes diarrhea linked to at least 14,000 American deaths each year. When you take antibiotics, good bacteria that protect against infection are destroyed for several months. During this time, you can get sick from C. difficile. The bacteria can be picked up from contaminated surfaces or spread from the healthcare environment. People, especially older adults, are most at risk who take antibiotics and also get medical care. Take antibiotics exactly and only as prescribed.
- Antibiotic resistance: The use of antibiotics may increase the risk of bacteria becoming resistant to them. Antibiotic-resistant infections can be very serious and difficult to treat.
What illnesses are caused by viruses and can’t be treated by antibiotics?
Viruses cause most upper respiratory infections, which include head colds, sore throats, bronchitis, and sinus infections. Viruses cannot be treated by antibiotics.
The common cold and flu (influenza) do not respond to antibiotics. Less than 10% of acute bronchitis cases are caused by bacteria. Most cases of acute ear infections also resolve without antibiotics.
Sore throats are usually caused by viruses as well. Antibiotics are not recommended unless you have strep throat. Only about 15% to 30% of sore throat cases in children and up to 10% of cases in adults are due to strep throat.
Almost all cases of acute bacterial sinusitis resolve without antibiotics.
The bottom line: Taking antibiotics for most acute upper respiratory tract infections does little or no good, and the downsides are real.
What’s making you sick: viruses or bacteria?
- Cold/Runny Nose: Virus
- Bronchitis/Chest Cold (in otherwise healthy children and adults): Virus
- Whooping cough: Bacteria
- Flu: Virus
- Strep throat: Bacteria
- Sore throat (except strep): Virus
- Fluid in the Middle Ear (otitis media with effusion): Virus
- Urinary Tract Infection: Bacteria
How are viruses treated?
Symptoms caused by viruses are usually treated with the over-the-counter drugs (drugs you can buy without a prescription). Some drugs reduce pain, such as acetaminophen (Tylenol®). Other drugs help make breathing easier (decongestants), and or relieve sneezing and runny nose (antihistamines). Symptoms can also be treated by gargling with salt water or drinking warm tea.
The best defense against getting the flu is to get a flu shot. The flu shot, however, does not protect against other viruses that cause other illnesses.
For some patients, a doctor may prescribe an antiviral drug, such as oseltamivir (Tamiflu®). These patients have a confirmed diagnosis of the flu and have risk factors for flu-related complications. These risk factors include:
- Chronic obstructive pulmonary disease (COPD)
- Heart, liver or kidney disease
- Age older than 65
- Living in a nursing home
- Weakened immune system due to cancer or HIV or organ transplantation – the immune system is the body’s defense system against infections
Although oseltamivir (Tamiflu®) does not “cure” the flu, it can shorten the amount of time with symptoms.
Finally, there are a few situations in which antibiotics are needed. See your healthcare provider if you have a weakened immune system due to cancer, or if you are taking steroids, have HIV, or have had an organ transplant. Also call if your symptoms worsen or last longer than 7 to 10 days.
If you think you may be getting the flu and you already have these conditions, you may be less able to fight bacterial infections should they occur.
How does my healthcare team know I need to take antibiotics?
The healthcare team may run tests to determine whether you need an antibiotic at all, and if so, which will work best. For example, your blood or urine may be checked for bacteria.
During treatment things may change. More tests and more information may show a different antibiotic is needed, or that this is a different type of infection. Tests may show that the antibiotic is not working. Or they may show an infection that cannot be treated with antibiotics.
Antibiotics can interact with other drugs you take, making those drugs or the antibiotics less effective. Some drug combinations can worsen the side effects of the antibiotic or other drug. Common side effects of antibiotics include nausea, diarrhea, and stomach pain. Sometimes these symptoms can lead to dehydration and other problems. Ask your doctor about drug interactions and potential side effects of antibiotics. Notify your doctor right away if you have any side effects from antibiotics you are taking.
What questions should be asked about treatment with antibiotics?
It is important to understand what is happening with you or your loved one’s care. Here are a few important questions caregivers or patients should ask about antibiotic treatment:
- What infection is this antibiotic treating? How does the healthcare team know that is the infection?
- What side effects might occur from this antibiotic?
- How long should these antibiotics be taken?
- Are there special instructions on taking this antibiotic, such as which medications or supplements are safe to take with it, or if it should be taken with food?
- What tests or monitoring will be done during treatment to show that the antibiotic is working?
Side Effects of Amoxil (Amoxicillin), Warnings, Uses
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Antibiotic-associated diarrhea – Symptoms and causes
Antibiotic-associated diarrhea refers to passing loose, watery stools three or more times a day after taking medications used to treat bacterial infections (antibiotics).
About 1 in 5 people who take antibiotics develop antibiotic-associated diarrhea. Most often, antibiotic-associated diarrhea is mild and requires no treatment. The diarrhea typically clears up within a few days after you stop taking the antibiotic. More-serious antibiotic-associated diarrhea requires stopping or sometimes switching antibiotics.
For most people, antibiotic-associated diarrhea causes mild signs and symptoms, such as:
- Loose stools
- More-frequent bowel movements
Antibiotic-associated diarrhea is likely to begin about a week after you start taking an antibiotic. Sometimes, however, diarrhea and other symptoms don’t appear until days or even weeks after you’ve finished antibiotic treatment.
Clostridioides difficile (formerly Clostridium difficile) infection
C. difficile is a toxin-producing bacterium that can cause a more serious antibiotic-associated diarrhea. In addition to causing loose stools and more-frequent bowel movements, C. difficile infection can cause:
- Severe diarrhea and dehydration
- Lower abdominal pain and cramping
- Low-grade fever
- Loss of appetite
When to see a doctor
Call your doctor right away if you have serious signs and symptoms of antibiotic-associated diarrhea. These signs and symptoms are common to a number of conditions, so your doctor might recommend tests — such as stool or blood tests — to determine the cause.
Why antibiotic-associated diarrhea occurs isn’t completely understood. It’s commonly thought to develop when antibacterial medications (antibiotics) upset the balance of good and bad bacteria in your gastrointestinal tract.
The antibiotics most likely to cause diarrhea
Nearly all antibiotics can cause antibiotic-associated diarrhea. Antibiotics most commonly involved include:
- Macrolides, such as clarithromycin
- Cephalosporins, such as cefdinir and cefpodoxime
- Fluoroquinolones, such as ciprofloxacin and levofloxacin
- Penicillins, such as amoxicillin and ampicillin
C. difficile infection
When antibiotics upset the balance of bacteria in your digestive system, the bacteria C. difficile can quickly grow out of control. C. difficile bacteria create toxins that attack the lining of the intestine. The antibiotics most commonly linked to C. difficile infection include clindamycin, fluoroquinolones, cephalosporins and penicillins — though taking virtually any antibiotic can put you at risk.
Antibiotic-associated diarrhea can occur in anyone who takes an antibiotic. But you’re more likely to develop antibiotic-associated diarrhea if you:
- Have had antibiotic-associated diarrhea in the past
- Have taken antibiotic medications for an extended time
- Are taking more than one antibiotic medication
One of the most common complications of any type of diarrhea is extreme loss of fluids and electrolytes (dehydration). Severe dehydration can be life-threatening. Signs and symptoms include a very dry mouth, intense thirst, little or no urination, dizziness, and weakness.
To help prevent antibiotic-associated diarrhea, try to:
- Take antibiotics only when necessary. Don’t use antibiotics unless your doctor feels they’re necessary. Antibiotics can treat bacterial infections, but they won’t help viral infections, such as colds and flu.
- Ask caregivers to wash their hands. If you’re receiving care at home or the hospital, ask everyone to wash his or her hands or use an alcohol-based hand sanitizer before touching you.
- Tell your doctor if you’ve had antibiotic-associated diarrhea or C. difficile before. Having antibiotic-associated diarrhea once or C. difficile in the past increases the chance that antibiotics will cause that same reaction again. Your doctor may be able to select a different antibiotic for you.
Aug. 11, 2021
Common Side Effects of Antibiotics
Antibiotics have become one of the most important tools of modern medicine. They offer an easy and effective means of treating infections that could otherwise be a serious threat to your health and make you very unwell. While they can make you feel better when you are sick, antibiotics can sometimes come with side effects. Let’s take a look at some common side effects of antibiotics and how you can reduce or prevent them.
What are Antibiotics?
Antibiotics, sometimes called antibacterials, refer to any medication that can effectively kill bacteria or stop the bacteria from reproducing, thus treating infections caused by bacteria.
Antibiotics were originally discovered in 1928, when Scottish doctor Alexander Fleming observed that a certain type of mold known as Penicillium notatum stopped the growth and spread of a type of bacteria called Staphylococcus. Staphylococcus bacteria can cause pneumonia, skin infections, and certain food-borne illnesses.
Further studies found that the mold could also kill Streptococcus, Diphtheria bacillus, Meningococcus, and other types of bacteria. From this research the first ever antibiotic, penicillin, was developed.
The antibiotics you are prescribed will depend on the type of bacteria causing the infection. Bacteria are generally divided into two groups, depending on the make-up of their cell walls:
Gram-positive bacteria have single-layered cell walls that are thin and easy to penetrate.
Gram-negative bacteria have thicker, double-layered cell walls that are not easily permeable.
To tackle these two types of bacteria, antibiotics are split up into several groups. In general antibiotics can be thought of as ‘broad spectrum’ or ‘narrow spectrum’, depending on how many bacteria and types of infection they are effective against.
- Broad spectrum antibiotics are designed to work against a wide variety of bacteria, both gram-positive and gram-negative. Broad spectrum antibiotics include quinolones and tetracyclines.
- Narrow spectrum antibiotics are only effective against either gram-positive or gram-negative bacteria but not both. Narrow spectrum antibiotics include penicillin and clindamycin.
Antibiotics use a variety of different mechanisms to eliminate or neutralize bacteria, but they generally work by:
- Directly killing bacteria by weakening their cell walls until they burst and die
- Inhibiting vital process that allow bacteria to grow and spread new cells
- Hampering a bacteria’s ability to repair any damage to its DNA, such that it dies
For example, quinolones, which are a type of broad-spectrum antibiotic, use hydroxyl radicals to eliminate bacteria. Hydroxyl radicals are molecules that destroy the proteins and lipids that make up the cell membrane in bacteria. These molecules can also damage cell DNA to prevent the bacteria cells from replicating.
Other antibiotics, like penicillin, eliminate bacteria by destroying the cell wall. Without a cell wall, bacteria can’t keep themselves together, forcing them to burst and die.
Why Antibiotics Cause Side Effects
Your body is naturally filled with millions of bacteria. Most of them are harmless, and many are actually beneficial or necessary for your health and general processes. Your gut bacteria, for instance, help you digest food properly.
Antibiotics can kill bacteria effectively, but they can’t always differentiate between good bacteria and bad bacteria. This means they may damage bacteria that you need, which can keep your body from operating properly while allowing the foreign bacteria greater reign over your organ systems.
Common Side Effects of Antibiotics
Some of the most common side effects you may experience with antibiotics include:
- Upset stomach – Many antibiotics can cause an upset stomach or other general gastrointestinal problems. This is most common with penicillins, cephalosporins, macrolides, and fluoroquinolone antibiotics. Symptoms include:
- Stomach cramps
- Photosensitivity – Certain antibiotics, like tetracycline, can make you more sensitive to light. This can make your skin more susceptible to sunburn, and your eyes may be more sensitive to natural light.
- Fever – Fever is a common side-effect of many medications, not just antibiotics. . Fever can also happen as part of an allergic reaction (more on this later). Fevers are more common with sulfonamides, cephalexin, beta lactams, and minocycline, but they can happen with any antibiotic.
- Tooth discoloration – Children whose teeth are still developing may suffer from permanent tooth staining when using antibiotics such as doxycycline and tetracycline. This is generally more common in children younger than eight years old.
Women who take antibiotics while pregnant may also stain the teeth of their developing child, so pregnant women should not take these types of antibiotics
- Fungal infections – Because antibiotics kill off lots of the healthy, protective bacteria in your body, they can cause certain fungal infections, particularly thrush. Thrush often appears as white, painful patches in your mouth and on your tongue. Antibiotics can also cause vaginal yeast infections, which can cause itchiness, pain, and general discomfort along with a fluid discharge. You might need treatment for these fungal infections and should seek advice from a doctor if you develop these symptoms.
- Interactions with Other Medications – Some antibiotics may affect the effectiveness of other medications you are taking. For example, the antibiotic rifampin can affect the effectiveness of the birth control pill.
Read: Do Antibiotics Make You Tired?
Serious Antibiotics Side Effects
Most side effects of antibiotics are not serious and should subside once you finish the course. However, depending on the sensitivity of the side-effects and your personal health, you may experience some more serious side effects, though these are rare.
Allergic reactions can happen with antibiotics and any medication. Allergic reactions to antibiotics can be relatively mild, but some can be very serious and require immediate medical attention.
If you are allergic to a certain antibiotic, you will react to it almost immediately after administration. Symptoms differ based on the person, but most allergic reactions manifest in the form of hives, trouble breathing, and swelling in the tongue and throat. If you have a severe allergic reaction to an antibiotic, known as ‘anaphylaxis’, this can be life-threatening. If you develop these symptoms you should seek medical advice immediately.
Another type of allergic reaction that can occur with antibiotics is Stevens-Johnson syndrome. Stevens-Johnson syndrome is a serious illness affecting your mucus membranes and skin. It is most common with sulfamethoxazole and beta-lactam antibiotics. Stevens-Johnson syndrome starts out with flu-like symptoms, including sore throat and fever and can progress to a painful rash that quickly spreads and causes blisters. This may be followed by the top layer of your skin shedding.
Other symptoms of Stevens-Johnson syndrome include:
- Skin pain
- Swelling in your tongue or face
- Pain in your throat and mouth
If you develop signs and symptoms of Stevens-Johnson syndrome you should stop taking the antibiotic immediately and seek medical advice straight away.
In rare instances, antibiotics can cause changes to your blood. For instance, some antibiotics can reduce the number of white cells in your blood (leukopenia). This can cause a weakened immune system and a higher chance of infections. Some antibiotics may cause low levels of platelets in your blood (thrombocytopenia). Platelets are needed for you body to form clots if you cut yourself, so not having enough can slow down your blood clotting and cause problems with bruising and bleeding.
Some antibiotic medications, usually fluoroquinolone antibiotics such as ciprofloxacin, may also irritate or inflame your tendons. Tendons are the thick tissues that connect your muscles to your bones. Continued irritation can potentially lead to tendonitis or a ruptured tendon. This is more common in people who:
- Suffer from existing kidney failure
- Have undergone a lung, heart, or kidney transplant
- Experienced past problems in their tendons
- Are 60 years old or older
- Take steroids
In the rarest cases, antibiotics can cause low blood pressure, irregular heartbeat, and other cardiovascular problems. These side-effects have been linked to erythromycin and some types of fluoroquinolone antibiotics.
To read about penicillin allergy click here
To read about amoxicillin allergy click here
Reducing and Preventing the Side Effects of Antibiotics
The best thing you can do to reduce the potential for antibiotics side effects is to take them as the label and follow your doctor’s instructions. Most antibiotics should be taken with food, as this can help to improve absorption and prevent an upset stomach. However, some must be taken with just water on an otherwise empty stomach – always read the information provided with the antibiotic you are prescribed. Talk to your doctor about ways to prevent upset stomach if you cannot take antibiotics with food.
Most gastrointestinal problems (diarrhea and soft stools) come from the fact that the antibiotics are killing the good bacteria in your gut, which disrupts the balance. There is some evidence to suggest that taking probiotics can help to replenish your gut flora and regain the bacteria balance in your digestive tract.
While the role of probiotics needs more research, you will certainly do no harm by taking a probiotic supplement or eating foods rich in probiotics, such as yogurt, sauerkraut, kimchi, kombucha, and most fermented foods.
While taking antibiotics you should avoid alcohol. Although alcohol is a fermented beverage, is does not have the same beneficial properties of other probiotic foods. Alcohol can in fact cause some of the same side effects as antibiotics, and so putting them together can make you feel much more unwell. Certain antibiotics, such as metronizadole, trimethoprim, and sulfamethoxazole, can cause severe reactions when combined with alcohol, leading to symptoms like:
- Flushing or redness in the face
- Increased heart rate
- Nausea and vomiting
Completing the Course of Antibiotics
Make sure you take the complete course of antibiotics as directed by your doctor to completely eliminate the bacteria from your system and treat the infection properly. Even if it seems like your symptoms have cleared up, there may still be lingering bacteria.
Stopping antibiotics early gives these bacteria a chance to grow and spread again, this time with the higher chance of becoming resistant to antibiotics. This could lead to more severe symptoms and require more intense antibiotics that could cause more serious side effects.
You should also only take the dose prescribed by your doctor, and do not increase your dosage unless your doctor instructs you to do so. Most antibiotics will take effect within the first few hours of administration, and you should feel better within the first day. If you do not feel better or if your symptoms do not improve within the first few days, contact your doctor. You may require a different antibiotic or may have been misdiagnosed.
How to Obtain Antibiotics
Getting the antibiotics you need is a relatively easy process, but you do need a prescription for them. Start by contacting your doctor. They will perform a physical examination and ask about your symptoms and personal health history. From there, your doctor may have enough information to provide a diagnosis and prescribe any necessary medication.
However, your doctor may need to order lab tests to get a better idea of the type of bacteria that is causing your illness. They may take a sample, often by swabbing your cheeks or drawing blood, and send it to a lab, where tests are run to identify the specific bacteria. Once the doctor has the results, they can prescribe the antibiotic that will target that bacteria and treat your infection most effectively
Despite the potential for side effects, if you have an infection and need antibiotics, the benefits far outweigh the risks. If you have symptoms of an infection and think you need antibiotics, you can get antibiotics online from a professionally trained and certified doctor by scheduling an appointment with PlushCare today.
Read More About Common Side Effects of Antibiotics
Read More of Our Antibiotics Series
Do Antibiotics Make You Tired?
Can Antibiotics Make You Feel Tired?
Yes, drowsiness is one of the most commonly reported side effects of antibiotics and it can seriously impact your quality of life. Since antibiotics are widely prescribed, it’s natural to wonder whether they can make you tired.
Below, we’ll take a look at the most common side effects of antibiotics, which antibiotics could make you tired, and what to do if a medication is making you drowsy.
What Are Antibiotics?
Antibiotics are medications that kill bacteria or stop them from reproducing. They are used to treat bacterial infections and are not effective against viral infections. There are many different kinds of antibiotics and each is used to treat a different type of infection.
The two general groups of antibiotics include:
- Broad-spectrum antibiotics work against many different types of bacteria and are useful when it’s unknown which bacteria is causing the infection.
- Narrow-spectrum antibiotics are only effective against certain types of bacteria and may work best when the bacteria causing the infection has been identified.
There are three main ways that antibiotics work:
- Weakening the cell walls of bacteria until they burst, killing the bacteria
- Preventing bacteria from repairing damage to its DNA, causing it to die
- Stopping a process that helps bacteria reproduce and spread to new cells
What Are the Most Common Side Effects of Antibiotics?
While each antibiotic may have slightly different side effects, the most common antibiotic side effects include:
- Upset stomach. Nausea, vomiting, diarrhea, and stomach cramps are some of the most common side effects of antibiotics.
- Fevers are a common side effect of many medications, including antibiotics, although the infection the antibiotic has been prescribed to treat may also cause a fever.
- Headaches may be caused by antibiotics.
- Anxiety or depression may be triggered by, or worsened by, some antibiotics.
- Light sensitivity. People taking antibiotics may sunburn more easily or their eyes may be more sensitive to light.
- Fungal infections. Bacteria often help keep yeast and other fungi under control, so antibiotics can lead to yeast infections or thrush.
- Tooth discoloration may happen, most commonly in children under the age of eight.
- Allergic reaction. Symptoms of an allergic reaction to an antibiotic may include hives, rash, shortness of breath, or anaphylaxis.
Read: Get Your Antibiotics Online
Why Do Antibiotics Cause Side Effects?
Any medication can cause side effects, and there are many different ways that medications can trigger them. Sometimes, your body’s immune system overreacts to medication, causing an allergic reaction. Some medications have a chemical structure that can affect your body in unpredictable ways.
One of the reasons antibiotics can cause side effects is because they kill all bacteria, not just the bad ones. Your body is full of beneficial bacteria, especially in your digestive tract, which is why stomach problems are such a common side effect of antibiotics.
Taking probiotics may help lessen antibiotic side effects that are caused by the loss of beneficial bacteria.
Always follow your doctor’s directions when taking antibiotics. Some antibiotics should be taken with food, which may lessen digestive problems that can be triggered by antibiotics. Other antibiotics must be taken on an empty stomach.
Which Antibiotics Could Make You Tired
Luckily, tiredness is not a common side effect of most antibiotics. Some antibiotics are more likely to cause fatigue than others, including:
- Azithromycin (Zithromax, Z-Pak)
- Ciprofloxacin (Cipro, Proquin)
- Amoxicillin (Amoxil)
What to Do if Antibiotics Make You Tired
If antibiotics make you tired, there are a few things you can do, including:
- Give your body a few days to adjust to the medication
- Avoid driving and other activities that require alertness, if possible
- Get plenty of sleep
- Avoid taking over-the-counter medications that may also cause drowsiness
- Don’t drink alcohol or take other substances that may cause fatigue
- Ask your doctor or pharmacist if you can take the antibiotic at night
If fatigue is making it difficult to function, talk to your doctor about whether there’s another antibiotic that may work without causing you to feel tired. Never stop taking an antibiotic without talking to your doctor first, because it may cause your infection to come back. Stopping antibiotics before finishing the whole course is also a big contributing factor to antibiotic-resistant bacteria.
Possible Interactions with Antibiotics
Antibiotics may have potentially serious interactions with other medications. Always tell your doctor about all the medicine you take, including over-the-counter medications. Some medications that are more likely to have interactions with antibiotics include:
- Anti-inflammatory drugs
- Blood thinners
- Muscle relaxers
Antibiotics may also reduce the effectiveness of certain types of birth control. Ask your doctor if you should use a backup method of birth control while taking antibiotics.
Read: Do Antibiotics Affect Birth Control?
Other Medications That Can Make You Feel Tired
Many medications can cause tiredness. The most common culprits include:
- Anti-anxiety medications
- Blood pressure medications
- Cough medicine
- Heart drugs
- Pain drugs
- Radiation therapy
Can antibiotics make you feel unwell?
The most common side effects of antibiotics include nausea, vomiting, diarrhea, and stomach cramps, so yes, antibiotics can make you feel unwell.
Does amoxicillin make you tired?
Fatigue is one possible side effect of amoxicillin, but not everybody who takes amoxicillin will feel tired after taking it.
Can antibiotics make you dizzy?
Some antibiotics may cause dizziness. A dizzy feeling may also be caused by your illness or dehydration.
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If you’re dealing with an infection and don’t want to go to the doctor’s office, you may be able to get antibiotics online by having a video or phone appointment with one of the trusted PlushCare doctors. You’ll tell the doctor about your symptoms, talk about your medical history, and mention any medications you’re taking. If the doctor thinks antibiotics are appropriate, they can send an electronic prescription to your pharmacy.
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Read More About Antibiotics
Antibiotics – Side effects – HSE.ie
Antibiotics can cause side effects. Most do not cause problems and serious side effects are rare.
Common side effects
The most common side effects are:
- feeling sick (nausea)
- being sick (vomiting)
- bloating and indigestion
- tummy pain
- loss of appetite
- skin rash
These are usually mild and should pass once you finish your course of treatment.
Some people have allergic reactions to antibiotics.
If you know you’re allergic to a type of antibiotic, tell your doctor or pharmacist.
In rare cases, an antibiotic can cause a severe allergic reaction. Symptoms of a severe allergic reaction include:
- breathing difficulties
- clammy skin
If you’ve had an allergic reaction to an antibiotic, do not take that antibiotic again. In rare cases, your doctor may need to consider prescribing an antibiotic you’ve been told to avoid.
Other side effects
Some people who take antibiotics get thrush (candida) of the mouth or vagina.
This is because antibiotics kill your body’s ‘good’ bacteria, along with the ‘bad’ bacteria. Our good bacteria normally stop thrush, a fungal infection, from happening.
Contact your pharmacist or doctor if your mouth or vagina gets sore or has a white coating while you are on antibiotics.
Read more about thrush
Antibiotics can cause diarrhoea. One type of diarrhoea caused by antibiotics is C. diff (Clostridioides difficile). In most cases, this is mild but it can be severe.
If you have diarrhoea while taking an antibiotic talk to your doctor, nurse or prescriber.
Read more about C. diff
Some antibiotics can make your skin sensitive to light. Speak to your doctor or prescriber if you have this side effect.
Severe aches and pains
In rare cases, antibiotics can cause long-lasting or permanent side effects. They can impact your joints, muscles and nervous system.
Contact your doctor if you have tingling, numbness or pain in tendons, muscles or joints.
90,000 5 side effects of antibiotics you didn’t know about
Despite the high efficiency in the treatment of many diseases that were previously considered incurable, the field of application of antibiotics is limited by strict indications, and their intake may be accompanied by a number of adverse reactions that may appear during treatment. And this must be remembered by everyone who starts therapy with antibacterial drugs.
Most often, antibacterial drugs lead to nausea and disruption of the gastrointestinal tract.But in fact, there can be many more side effects from these drugs. And scientists periodically add to the list of adverse reactions that may occur when taking antibiotics.
It happens that we ourselves decide to start taking antibiotics to fight diseases that have led to an increase in body temperature. At the same time, we hope that the temperature will drop. But it may turn out the other way around. It turned out that antibacterial drugs, in a certain percentage of cases, can cause fever or aggravate it. 1 This is one of their side effects, which is observed in a number of antibiotics, including those used to treat complications of acute respiratory viral infections.
If the body temperature rises after taking antibiotics or if the previously onset of fever intensifies, it is necessary to stop taking the drug and seek medical help from a doctor. Don’t wait for the fever to get too strong. The lack of positive dynamics may indicate the ineffectiveness of this drug, which requires a medical decision and correction of therapy.High body temperature negatively affects metabolism, which can lead to a violation of the water-salt balance when the nervous, cardiovascular and urinary systems are affected. 2
Such conditions are life-threatening, therefore, before treatment, it is necessary to make an informed decision and start antibiotic treatment only if there are good reasons and after consulting a doctor.
Antibiotics can lead to dysbiosis and contribute to the development of fungal infections. 3 It turns out that you can treat one disease, and get another in the “load”.
Fungi can affect the mucous membranes of the gastrointestinal tract, as well as the skin and genitourinary system. If the fungal disease is generalized, that is, it has spread throughout the body, then there is a risk of damage to internal organs. 4
When a fungal disease develops, other infections are often added, which can lead to a sharp decrease in immunity, ulcers, even baldness and other unpleasant and dangerous consequences.To avoid such complications, doctors sometimes prescribe antibiotics along with antifungal drugs, which increases the burden on the body.
Of course, one of the most common side effects of antibiotics is allergies. 5 In this case, an itchy rash and swelling may appear on the skin. In severe forms, the eyelids, lips and tongue become swollen, difficulty swallowing and speaking is observed, severe weakness appears, there is a heaviness behind the breastbone and shortness of breath even at rest.This is how anaphylactic shock manifests itself – an acute pathological condition that is life-threatening. In the case of the rapid development of allergy symptoms, an ambulance and resuscitation are needed.
It is necessary to take into account the fact that antibiotics can enter our body along with some food – for example, meat can contain penicillins. This means that almost every person has a risk of developing allergies when taking antibacterial drugs. 6 This once again indicates the need for medical supervision when taking antibiotics.
Some antibacterial drugs are vestibulotoxic, that is, they can lead to dizziness. Disequilibration can also be observed – instability and uncoordinated movements. 7
All such symptoms must be immediately reported to your doctor, he will select another drug for you.
An unexpected side effect of antibiotics, isn’t it? In fact, we are talking about an increased risk of getting pregnant in those women who are simultaneously taking oral contraceptives and some drugs from the antibiotic group.The reason is that certain antibacterial drugs increase the production of enzymes in the liver, which increase the breakdown of estrogen from the pill, and thereby reduce the effectiveness of birth control pills. 8
Currently, scientists continue to study the mechanism of the effect of various antibiotics on contraceptives. If you are not planning a pregnancy, use additional barrier methods of contraception during treatment and for a week after the completion of the course.
What should be kept in mind?
It is necessary to be very careful with the choice of drugs and, if possible, choose those that have the greatest therapeutic and least toxic effects. Therefore, you should not take antibiotics if there is no indication for this and the doctor did not recommend these drugs to you.
With ARVI and sore throat, in most cases, it is advisable to choose symptomatic therapy, which helps to get rid of unpleasant symptoms, regardless of the cause of their occurrence.The drug Strepsils® Intensive, lozenges [honey-lemon] has a local analgesic and anti-inflammatory effect on the mucous membrane of the mouth and throat: reduces swelling, difficulty in swallowing, pain and irritation in the throat. 9
The drug helps to eliminate sore throat, regardless of the cause of its occurrence (whether it be viruses, bacteria or fungi).
Method of application and dosage
Adults and children over 12 years of age: Slowly dissolve one tablet every 3-6 hours.
Maximum daily dose: 5 tablets.
The duration of the course of treatment is no more than 3 days. If, after taking the drug for 3 days, the symptoms persist or worsen, it is necessary to stop treatment and consult a doctor.
Read the instructions before using the drug.
90,000 Recovery of the body after taking antibiotics
Now almost all of humanity is going through a difficult period – the countries are covered by a new, little-studied infection – COVID-19.A large number of people will have already faced with this ailment and recovered safely – but not without the help of antibiotics. It’s not a secret for anyone that taking antibiotics not only ko relieves a person of b harmful bacteria, but, unfortunately, causes some concomitant harm to health.
The undesirable consequences of taking antibiotics are that antibacterial drugs kill not only pathogenic microorganisms, but also the beneficial microflora that inhabits the intestines.In addition, the liver also suffers from the chemical components of the tablets, since the process of removing drugs from the body takes place through it.
That is why, after taking antibiotics, you need to help your body recover.
Restoration of microflora of intestines and immunity
Long-term use of antibiotics significantly impairs the intestinal microflora. The consequences of such a violation can be constipation, abdominal pain, excessive gas formation and, as a result, bloating.Due to the disruption of the intestines, a decrease in immunity also occurs, since 60% of immune cells are produced in the intestines.
Probiotics should be taken to prevent disturbances in the gut microbiota. This must be done both during antibiotic treatment and after, because lacto- and bifidobacteria increase the body’s nonspecific resistance, activate the immune system, synthesize vitamins of the K, B group, amino acids in the intestine, enhance intestinal parietal digestion, absorption of calcium, iron, vitamin D.
We recommend the following preparations:
• BAK-SET Cold / Flu * – a novelty of English production, containing 17 strains of beneficial bacteria that enhance each other’s action. Does not contain lactose, GMOs, artificial colors, therefore it can be offered to adults and children from 2 years old.
• Immucil * – in addition to bifidobacteria, contains vitamin C and zinc – integral companions of strong immunity.A convenient form of release (powder dissolved in the oral cavity) will allow you to receive treatment without interrupting your daily activities.
• Sinobactin Forte * is a foreign product made in Canada. Affordable price, convenient reception (1 capsule once a day), does not require refrigeration.
• Florasan-D * – a drug included in the industry standard for the treatment of irritable bowel syndrome (approved by the Russian Gastroenterological Association). Does not contain genetically modified microorganisms, lactose, gluten and sucrose, therefore it can be recommended for buyers suffering from intolerance to these
• Bificin * – the product is manufactured according to GMP standards in the USA. Thanks to the characteristics of capsules made using Bifi Guard® technology, beneficial bacteria are protected from acidic gastric contents, bile salts and digestive enzymes. Such protection allows them to freely pass the stomach, adapt and take root in the intestinal lumen, while maintaining high biological activity. Restoration of vaginal microflora Once in the body, antibiotics fight against the causative agent of the infection, but at the same time destroy other beneficial microorganisms, including lactobacilli.It is lactobacilli that protect the vaginal environment from the activation of pathogens.
When the concentration of beneficial lactobacilli decreases, harmful microorganisms grow, causing undesirable symptoms. As a rule, pathogens are more active and aggressive, they have time to multiply before the content of “good” bacteria returns to normal. As a result, vaginal dysbiosis occurs.
One of the most common results of such dysbiosis after taking antibiotics is candidiasis.Its symptoms: the appearance of atypical discharge, which differ in density, consistency, color and smell, itching, burning and irritation. An accurate diagnosis can only be made by a doctor, but due to the prevailing unfavorable epidemiological situation, the buyer can turn to a pharmacist for a recommendation and purchase of over-the-counter drugs. These are drugs based on fluconazole:
Diflucan and Fluconazole Medisorb. If the course of the disease is not very severe, a single dose of 150 g will be sufficient.drug. In case of recurrent chronic course, you should immediately consult a doctor.
If the customer is more accustomed to such a dosage form as vaginal suppositories, we recommend preparations based on natamycin (Pimafucin, Ekofucin, Primafungin) or sertaconazole (Zalain). The latter will be a real salvation for women who do not like long-term treatment.
Also, do not forget that the vaginal microflora needs to be restored. The intake of Sinobactin Forte * will have a great effect on women’s health – it contains the Lactobacillus casei HA-108 strain, which not only helps to restore the microbiome, but also helps to reduce the risk of recurrence of thrush.
The liver performs many functions, including neutralizing toxic substances that have entered our body. Taking antibiotics, especially long-term, can lead to the development of acute toxic hepatitis and hepatic cholestasis, in addition, it can negatively affect the bile ducts. Based on this, we can say with confidence that after taking antibiotics, the liver needs to be restored, and even if the negative consequences are invisible.
To maintain liver function, you should pay attention to the following means:
• Complex of oat and milk thistle extracts w and *. Milk thistle extract promotes the regeneration of liver cells and the speedy replacement of dying cells with young ones. Oat extract is useful for intoxication of the body, as it helps to remove harmful substances from the liver. It also improves the processes of bile formation and its excretion, thereby accelerating the decomposition of toxins and their subsequent removal from the body.
• Katrilan * contains silymarin, which activates protein synthesis in damaged liver cells – this contributes to their recovery. One package of the drug is enough for the course of administration.
• Esfolil * – a rich source of essential phospholipids, which are able to repair damaged cell walls, thereby protecting the liver from harmful effects.
• Lecirate * contains artichoke extract, which improves the detoxification function of the liver, and lecithin – a substance from which the walls of cell membranes are built, therefore its intake stimulates the regeneration of damaged liver cells.
After a previous illness, the human body is weakened and vulnerable to new infections, so it needs some support, which means that you should take care of taking such drugs as vitamin C, zinc, vitamin D and vitamin-mineral complexes (VMC).
• Verrum-Vit * – VMC for children and adults are presented in the series, and the new form of release (effervescent tablets) will satisfy the needs of all buyers.
• Zinc * and Zinkorol *.Research shows that zinc can interfere with the molecular process that causes mucus and bacteria to grow in the nasal passages. Zinc has an anti-viral effect by attaching to receptors in nasal epithelial cells and blocking their effects.
• Vitamin D triggers the synthesis of its own antimicrobial substances in the cells of the skin and epithelium of the respiratory and gastrointestinal tracts, destroying viruses, bacteria and fungi, thereby reducing the risk of developing colds.We recommend drops ( DeTriFerol , Detrimax *), tablets ( Detrimax *, Cosmo-D3 *) or capsules (Vitamin D * 400 and 2000 mg), based on dosages and preferences.
Timely measures taken will help you not only to transfer treatment with the least consequences, but also to protect your health in the future for !
THERE ARE CONTRAINDICATIONS, PLEASE READ THE INSTRUCTIONS OR CONSULT A SPECIALIST.
BIOLOGICALLY ACTIVE ADDITIVE. NOT A DRUG.
Clostridium difficile Infection / Diseases / Clinic EXPERT
The widespread use of antibiotics in Russia during 2020 (not least due to the SARS-Cov-2 virus pandemic) led to the fact that gastroenterologists began to meet more often with such complications of antibiotic therapy as antibiotic-associated diarrhea and colitis. One of the most common causes of these disorders (15-25% of cases) is Clostridium difficile infection (according to the new classification Clostridiodes difficile).
Clostridium difficile (C.difficile) is a spore-producing bacterium, first described in 1935. It causes a wide range of gastrointestinal disorders, from asymptomatic carriage to extremely severe (fulminant) colitis. When bacteria spores enter the gastrointestinal tract of a healthy person, they will transit without causing any changes. In some healthy individuals, the bacterium can be detected in stool samples, again without showing symptoms. In people with risk factors, spores germinate, which leads to the formation of vegetative forms of C.difficile. Some bacteria are capable of producing toxins, which leads to the development of the disease.
Some epidemiological data.
- The incidence of C.difficile in the United States is 500-700 thousand new cases annually, while mortality from severe forms reaches 15-20 thousand cases per year.
- C.difficile is the leading cause of nosocomial diarrhea in the United States and other developed countries
- In Europe and the United States, 20-27% of Clostridial infections are community-acquired, i.e.e. arising at the outpatient stage. Of these, almost a third of the episodes of the disease had no indication of antibiotic therapy during the previous 12 weeks
- The frequency of asymptomatic carriage of C.difficile in healthy individuals is 2-8%, in hospitalized patients – up to 20%.
Risk factors for the development of diseases caused by C..difficile.
1) Antibiotic therapy for 8 weeks prior to onset of intestinal symptoms. Antibiotic therapy increases the risk of infection by 8 times.
2) Age over 65 years (for outpatients, the risk is lower than for hospitalized patients)
3) Inpatient treatment for more than 4 weeks (and stay in long-term care facilities, hospices). Each week of hospitalization increases the risk of infection by 8%. Being in an intensive care unit doubles the risk.
4) Chemotherapy and the use of immunosuppressants
5) Taking drugs from the group of proton pump inhibitors (the risk increases 2.9-3.6 times)
6) Concomitant diseases (chronic kidney disease, including those requiring dialysis, stroke, diabetes mellitus, chronic heart failure, alcoholism, chronic obstructive pulmonary disease, malnutrition, HIV infection, cancer, inflammatory bowel disease, etc.and conditions (pregnancy).
As you can see, antibiotics are in the first place among the risk factors for the development of Clostridial infection. It is the antibiotic-associated disorders caused by C.difficile that are most often found in the practice of a gastroenterologist. All antibiotics for the risk of developing C..difficile infection are divided into three groups:
1) high risk – fluoroquinolones (ciprofloxacin, etc.), cephalosporins of 2 and 3 generations, clindamycin, ampicillin, broad-spectrum penicillins with clavulanic acid;
2) moderate risk – macrolides, trimethoprim / sulfamethoxazole, sulfonamides, other penicillins;
3) low risk – aminoglycosides, bacitracin, metronidazole, teicoplanin, vancomycin, rifampicin, chloramphenicol, tetracycline, carbapenems, daptomycin, tigecycline.
Ways of infection and pathogenesis.
C.difficile is widely distributed in the environment and is transmitted by the faecal-oral route. As mentioned above, the bacterium forms spores, which in an inactive form persist for a long time in the environment. The spore’s resistance to high temperatures, ultraviolet radiation and antibiotics makes the bacteria very viable.
Spores may persist in the human gastrointestinal tract and cause recurrence of C.difficile infection after successful treatment.
Outbreaks of infections in hospitals are caused by the transmission of spores through the hands of medical personnel or caregivers (including relatives). C.difficile spores are found in the wards of half of the infected persons.
The pathogenicity of C.difficile is due to the presence of two toxins – toxin A and toxin B . Bacteria that do not produce toxins do not cause disease. Some bacteria produce only toxin B, some produce both toxins. In recent years, strains of bacteria have been described that can also secrete double toxin (CDT).
After spores enter the human gastrointestinal tract, they germinate with the formation of vegetative forms of bacteria. Further, there is adhesion (adhesion) of bacteria to the cells of the epithelium of the colon and the production of toxins. An important role is played by the violation of competition from the normal intestinal microbiota, which changes after antibiotic therapy.
Toxin A causes inflammation of the colon mucosa and the secretion of fluid, it is with it that the development of watery diarrhea is associated with infection with C.difficile.
Toxin B is toxic to cells, and not only to the intestines. Increased production of this toxin can lead to the development of complications and damage to other organs and systems (for example, cardiovascular) in a severe course of the disease.
Classification of diseases caused by C.difficile.
According to the International Classification of Diseases 10 revision (ICD-10), the disease is coded as “enterocolitis caused by C.difficile” (code A 04.7).
The Russian Gastroenterological Association in its recommendations from 2016 identifies the following manifestations of C.difficile-associated disease, depending on the severity of its course:
1) Mild / moderate – diarrhea (loose stools 3 or more times a day) in combination with abdominal pain
2) Severe course:
- watery diarrhea with blood
- a decrease in the level of albumin in the blood
- an increase in the level of leukocytes
- tenderness on palpation of the abdomen
- 3) Complicated course
4) Recurrence of the disease – re-development of symptoms less than 8 weeks after the end of therapy.
The following formulations of diagnosis in a patient with C.difficile infection seem to be doubtful:
1) “Antibiotic-associated diarrhea” – only about 20% of cases of stool disorders after antibiotics are associated with C..difficile “
2)” Pseudomembranous colitis “- only in 50% of cases in the intestine are revealed “pseudomembranes” and only in severe colitis.
Until new data are obtained, the term proposed by the Russian Gastroenterological Association can be used: “C.difficile-associated disease “. Also, a descriptive diagnosis of “C.difficile-associated diarrhea” or “C.difficile-associated colitis”, depending on the severity of the disease, seems logical.
Clinical presentation of C.difficile-associated disease.
- Stool disorders of the type of diarrhea. The stool is loose, often watery, sometimes with mucus / blood. Symptoms often appear after exposure to a causative factor (such as antibiotics), on average 5-10 days. Cases of the debut of stool disorders from the first days of treatment and even 10 weeks after the end of antibiotic therapy have been described.
- Abdominal pain occurs in patients with a severe course of the disease
- Weight loss
- An increase in body temperature may occur with a more severe course of C.difficile-associated disease
- Complications in the form of toxic dilatation of the intestine, perforation are rare.
- Extraintestinal manifestations in the form of arthritis, skin abscesses are rare in severe (fulminant) colitis caused by C.difficile
Diagnosis of C.difficile-associated disease.
1. Study of feces. A stool sample for the best diagnosis of C.difficile infection is loose (preferably liquid) fresh stool. For persons with intestinal obstruction without stool – an intestinal smear.
Modern methods for diagnosing C.difficile infection in feces include:
A. Polymerase chain reaction (PCR) for the diagnosis of toxin-producing C.difficile strains.
Advantages : a method with high specificity and sensitivity, considered in many recommendations as the “gold standard” of diagnostics.Short lead times.
Disadvantages : Requires a specialized laboratory for molecular genetic diagnostics. It can be the cause of overdiagnosis, since it detects not the toxins in the feces themselves, but only the bacteria that can produce them.
B. Enzyme-linked immunosorbent assay (ELISA) of feces for the detection of toxins A and B C.difficile.
Advantages of : the most accessible method, fairly high specificity.
Disadvantages : low sensitivity, i.e.That is, not all cases of overt infection will be detected by the test. Sensitivity depends on the type of test system. Not all commercial test systems determine toxin B.
B. Study of glutamate dehydrogenase (GDD) in feces.
GDD is an enzyme produced by C.difficile.
Advantages of : high sensitivity and specificity of the method. Very fast exploration (up to 30 minutes).
Disadvantages : HDD is produced by both toxigenic and non-toxic strains of C.difficile. In Russia, this method is still practically unavailable.
2. Colon endoscopic diagnostics (colonoscopy).
With C.difficile-associated diarrhea, changes in the mucous membrane of the colon are usually nonspecific: edema, hyperemia (redness), sometimes in the form of foci.
With C.difficile-associated colitis, when intestinal inflammation is more pronounced, erosions and ulcers can be detected. Severe inflammation is accompanied by the formation of “pseudomembranes”.These are overlays on the mucous membrane of a yellow-green, white-yellow or pink color, which are difficult to separate. Pseudomembranes are detected only in half of the cases of colitis caused by C.difficile; in all other situations, the endoscopic picture of inflammation is not very specific. This leads to misdiagnoses: ulcerative colitis, Crohn’s disease, especially if there was no indication of taking antibiotics.
Treatment of C.difficile-associated disease.
1. Procedures for isolating the patient and preventing the spread of infection (relevant in the hospital):
- Washing hands with soap under running water for all visitors who come into contact with the patient (visitors and staff) – removal of C.difficile from the skin of hands
- Use of gloves and gowns by staff and visitors
- Allocation of a separate room and toilet (if impossible – use of the vessel)
- Daily treatment of horizontal surfaces in the ward and equipment with chlorine-containing solutions
2. Therapy of the disease includes:
- withdrawal of the antibiotic that provoked C.difficile: vancomycin, metronidazole, fidaxomicin *
- fecal transplant (fecal transplant) * – in case of ineffectiveness of standard therapy or frequent recurrence of infection, the effectiveness exceeds 90%.
- surgical treatment (colectomy) in case of extremely severe course and / or ineffectiveness of all treatment methods
* not registered in the Russian Federation
Prevention of C..difficile infection.
1) Use of antibiotic therapy only when indicated
2) Use the minimum effective duration of antibiotic treatment
3) Currently available scientific data on the effectiveness of pro- and probiotics in preventing the development of C.difficile are insufficient. There is little evidence for Saccharomyces boulardii.
Depends on the severity of the disease. Mild / moderate forms of C.difficile-associated disease are often easy to treat and do not recur. A severe (fulminant) course may require intensive therapy and even surgery.
Do probiotics help restore the intestinal microflora?
- Marta Henriquez
- BBC Future
Photo Credit, Unsplash
Antibiotic treatment can destroy not only harmful bacteria, but also beneficial ones.However, do probiotics help restore the gut microflora, as their ubiquitous advertising insists?
Probiotics are heavily advertised as a remedy for problems ranging from obesity to mental health problems. But most often they are recommended to restore the intestinal microflora after a course of antibiotics.
The logic is simple: during the treatment of an infection, antibiotics destroy all bacteria, both harmful and beneficial, and therefore the intestines must be repopulated with new bacteria.
However, the effectiveness of this method is practically not proven. What’s more, the researchers found that consuming probiotics after antibiotics actually delayed the restoration of gut flora.
The problem is that there just isn’t enough research on any particular probiotic. Even when scientists use strains of live bacteria, the composition of the cocktail can vary greatly from laboratory to laboratory.
This is the opinion of Sidney Newberry of the Rand Corporation, who analyzed a large database of probiotic use in the treatment of antibiotic-induced diarrhea in 2012.
Newberry reviewed 82 studies with a total of 12,000 patients. He concluded that probiotic supplementation did help reduce the risk of digestive upset, but it was impossible to figure out which probiotic or probiotic blend was effective.
Photo author, Getty Images
Pidpis to photo,
It is widely believed that antibiotics, along with harmful ones, destroy beneficial bacteria in the intestine.
First of all, there is a lack of research that would prove the safety of taking probiotics.As a rule, probiotics do not harm the body of a healthy person.
But there is also more alarming evidence that probiotics may promote the spread of fungal infections in the bloodstream in more vulnerable patients.
Recently, scientists at the Weizmann Institute of Science in Israel proved that even in healthy people, the use of probiotics after antibiotics was not so safe.
Probiotics, as scientists have found, interfered with the very process of recovery, that is, their action was actually the opposite.
Scientists divided the participants in the experiment, who had just finished taking antibiotics, into three groups.
One group began to take probiotics, the second – the control – did not take anything, and the third received a fecal transplant. The participants in this group received a stool sample taken from them before taking antibiotics.
Photo author, Getty Images
Pidpis to photo,
Probiotics do not have the same effect on everyone, since the intestinal microbiome is different for all people
The result was unexpected.The worst result was for those who took the probiotics, and the best for the group that received the faecal transplant. It took only a few days for the intestinal microflora to fully recover.
There is a growing body of evidence that probiotics can harm unhealthy gut.
One recent study found that probiotics were of no benefit to children admitted to hospital with gastroenteritis.
However, despite these findings, the demand for probiotics is not only not decreasing, but growing.In 2017, the sales market for probiotics amounted to more than $ 1.8 billion, by 2024 it may grow to $ 66 billion.
“Given this scale of production, it is very important that the benefits of probiotics are properly proven,” notes Eran Elinav of the Weizmann Institute.
“This is also the reason that regulatory bodies such as the US Food and Drug Administration and similar European institutions have not yet approved the clinical use of probiotics,” the scientist adds.
Photo author, Getty Images
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Probiotics can harm unhealthy intestines
This, however, does not mean that probiotics should be completely abandoned. The problem is obviously not with the probiotics themselves, but with how we take them.
Such drugs are often bought without a prescription, and the consumer has no idea what exactly he bought and whether the bacteria in it are alive at all.
Elinav and his colleagues also tried to find out who might benefit from taking probiotics.
By examining the work of genes associated with the immune system, scientists were able to predict whether the patient’s intestines will be susceptible to saturation of beneficial bacteria, or they will just pass by without delay.
“This is an interesting and important study because it also says that our immune system interacts with probiotic bacteria,” explains Elinav.
It paves the way for the development of personalized probiotic therapies based on a person’s genetic profile.
This approach is “absolutely realistic and can be developed relatively quickly,” notes Elinav, but so far this is only a theoretical argument.
Development will require more research on individual probiotic selection and testing of different strains of bacteria in large populations.
The lack of consistent research on probiotics so far is also explained by the fact that they have always been treated like conventional medicines.
When you take a pill of paracetamol, you are more or less confident that its active component will act on the receptors in your brain and reduce pain.After all, the mechanism of pain in most people is approximately the same.
But the microbiome is not a receptor, but rather an ecosystem that is sometimes compared in complexity to a rainforest.
And therefore, finding probiotics that will help restore such a complex and individualized internal ecosystem is not an easy task.
And it is also quite understandable why a bag of dry bacteria from a supermarket shelf is unlikely to cope with this task.
Dysbacteriosis after antibiotics – symptoms, causes and treatment
The discovery of antibiotics helped save the lives and health of many people in situations in which previously doctors could only count on a miracle 1.8 .However, antibiotics are capable of destroying not only pathogenic bacteria, but also representatives of the normal intestinal microflora. Therefore, they can be one of the reasons for the disturbance of the healthy balance of microorganisms in the intestinal lumen and can contribute to the development of dysbiosis 2 . Why antibiotics can cause dysbiosis and can it be dealt with? We have found for you the answers to these and other important questions about the complex relationship between antibiotics and intestinal microflora.
Who lives in a healthy intestine?
Complete intestinal health is impossible without microorganisms, which begin to colonize the gastrointestinal tract from the first days of a child’s life, and gradually form a moderately stable bacterial composition environment that helps the body to digest food and get the necessary nutrients 3.4 .
Bifidobacteria and lactobacilli, as well as bacteroids, enterococci and Escherichia coli, prevail in the normal intestinal microbial flora. They and several other types of bacteria are called obligate, that is, permanent, intestinal flora. Obligate flora makes up 95-98% of the normal intestinal microflora. Other types of microorganisms belong to the additional and transient microflora (1-4%). It includes fungi, staphylococci and opportunistic microbes that pose a potential threat to human health 4 .Each group of microorganisms has a different degree of susceptibility to antibiotics 3 .
The role of normal microflora in digestion and not only
It has been established that the violation of the intestinal microflora is associated not only with the development of diseases of the digestive system, but also with the appearance of problems from other body systems that are not directly related to the processes of digestion 7 .
This is because bacteria that live in a healthy intestine do work that affects many important processes in the human body:
- Enzyme production 3.6 .
- Participation in the immune system. Bifidobacteria stimulate the formation of certain types of antibodies, and lactobacilli increase the activity of individual cells involved in the immune response (lymphocytes, phagocytes) 3.6 .
- Protective function. The intestinal microflora secretes its own antimicrobial substances, which prevent the colonization of the digestive tract by pathogenic bacteria that inevitably enter it when eating 3 .
- Production of vitamins necessary for normal metabolism (vitamins of group K) 3,6,11 .
Causes of microflora disorders after taking antibiotics
Modern antibiotics are characterized by a wide spectrum of action, which, on the one hand, is good, as it helps to fight bacterial infections, even when their causative agent is not known. But on the other hand, it is impossible to direct the action of antimicrobial drugs only to harmful microorganisms. Some representatives of the normal intestinal microflora are also susceptible to them. They also break down and die during treatment 8 .Then microorganisms that are resistant to the drug are able to multiply more actively, taking the place of dead beneficial bacteria. So antibiotics change the qualitative and quantitative composition of the intestinal microflora and can lead to the activation of opportunistic microbes. Sometimes, after completing a course of antibiotics, the intestinal microflora is able to recover on its own, but this takes time, and recovery may be incomplete 8 .
Against the background of a violation of the normal composition of the intestinal microflora caused by taking antibiotics, symptoms characteristic of dysbiosis (loose stools, bloating, etc.) may occur.), but the condition is also asymptomatic. Restoring the normal balance of microorganisms in the intestines can help relieve these symptoms 8 .
Antibiotics: harm or benefit?
Without antibiotics, medicine would have lost a powerful weapon that allows you to quickly direct the course of many serious diseases towards recovery or ensure people recover without infectious complications after operations of varying degrees of complexity 1.8 . But the state of intestinal microflora after a course of treatment with antimicrobial drugs may worsen 2 .
Any use of an antibiotic must be justified, so avoid self-medication. And remember that disturbed microflora requires restoration 3.7 .
How to eliminate dysbiosis after antibiotics?
A modern approach to restoring the composition of normal intestinal microflora consists in the use of special preparations with different mechanisms of action:
- Metabiotics, metabolic products of bacteria of normal microflora, contributing to the restoration of normal intestinal microflora by biological means and allowing to preserve the physiological and biological functions of the intestinal mucosa;
- probiotics, which contain live bacteria and are designed to compensate for the lack of their own;
- prebiotics, a nutrient medium for the growth of bacteria.
Some of these drugs are considered not only as a means of restoring intestinal microflora after antibiotic treatment, but also as an element of a comprehensive treatment of intestinal disorders, improving the body’s defense against pathogenic bacteria 2,8,12 .
Khilak Forte is the # 1 metabiotic on the Russian market 9 . Hilak forte retains its effectiveness when taken together with antibiotics, since, unlike probiotics, it does not contain live bacteria, therefore its effect is not suppressed by the simultaneous intake of antibiotics.Another advantage of Hilak forte in the treatment of dysbiosis after and during the course of taking antibiotics is convenient forms of release (sachets and drops). One of the advantages of Hilak forte in the treatment of dysbiosis after or during the course of taking antibiotics is convenient forms of release (sachets and drops). As soon as the illness subsides after a course of antibiotic therapy, most people are forced to close sick leave and go to work, or simply rush to deal with the cases that have accumulated during their illness.Outside the home, people face difficulties in restoring intestinal microflora, because not all probiotics can be easily carried with them and taken anywhere at a convenient time. Hilak forte is released in the form of sachets, which can be safely carried in your bag or in your clothes pocket. Hilak forte helps to restore the normal balance of microorganisms in the intestines, wherever you are: at work or while traveling.
1. Lee Ventola C. The Antibiotic Resistance Crisis.P T. 2015 Apr; 40 (4): 277-283.
2. Francino M. P. Antibiotics and the Human Gut Microbiome: Dysbioses and Accumulation of Resistances. Front Microbiol. 2015; 6: 1543.
3. Ajigaitkanova S.K. Approaches to drug treatment of intestinal dysbiosis // RMZh. 2007. No. 2. P. 73.
4. Shcherbakov PL, Nizhevich AA, Loginovskaya VV, Shcherbakova M.Yu., Kudryavtseva LV, Mitrokhin SD, Nurtdinova NM, Ochilova RA. Intestinal microecology in children and its disorders. “Pharmateka” 2007, No. 14, p.28-34.
5. Fröhlich EE, Farzi A., Mayerhofer R., Reichmann F., Jačan A., Wagner B., Zinser E., Bordag N., Magnes C., Fröhlich E., Kashofer K., Gorkiewicz G., Holzer P. Cognitive impairment by antibiotic-induced gut dysbiosis: Analysis of gut microbiota-brain communication. Brain Behav Immun. 2016 Aug; 56: 140-55.
6. Morowitz, M. J., Carlisle, E., & Alverdy, J. C. (2011). Contributions of Intestinal Bacteria to Nutrition and Metabolism in the Critically Ill. The Surgical Clinics of North America, 91 (4), 771-785.https://journals.sagepub.com/doi/10.1177/1756283X10373814.
7. Carding, S., Verbeke, K., Vipond, D. T., Corfe, B. M., & Owen, L. J. (2015). Dysbiosis of the gut microbiota in disease. Microbial Ecology in Health and Disease, 26, 10.3402 / mehd.v26.26191. https://www.tandfonline.com/toc/zmeh30/current.
8. Langdon, A., Crook, N., & Dantas, G. (2016). The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation.Genome Medicine, 8, 39. https://journals.sagepub.com/doi/10.1177/1756283X10373814.
9. Hilak Forte – the leader in sales in money in 2016 among metabiotics according to AM EM ES Health.
10. Verna, E. C., & Lucak, S. (2010). Use of probiotics in gastrointestinal disorders: what to recommend? Therapeutic Advances in Gastroenterology, 3 (5), 307-319. https://journals.sagepub.com/doi/10.1177/1756283X10373814.
11. Conly J. M., et al. The contribution of vitamin K2 (menaquinones) produced by the intestinal microflora to human nutritional requirements for vitamin K.Am J Gastroenterol. 1994; 89 (6): 915-23 “.
12. Instructions for the use of a medicinal product for medical use.
90,000 Antibiotics are not only useful, but also dangerous – Science – Kommersant
Approximately 70% of Russians prefer to be treated with antibiotics for colds. Health professionals and experts are alarmed by such statistics, because uncontrolled self-medication can lead to serious consequences – from allergic reactions to anaphylactic shock.
The most common ailments that Russians seek to cure with antibiotics are colds and ENT diseases. Often, this leads to addiction to the drug and a decrease in its effectiveness for the body.
According to otolaryngologist, doctor of medical sciences, professor, head of the otolaryngology center “On clinics” Irina Kirichenko, the most common ailment in patients is chronic sinusitis without polyps, inflammation in the sinuses. This is due to the deterioration of the environmental situation, extreme sports (rock climbing, diving) and the fact that patients are self-treated with antibiotics, she explains.
“A lot of patients prescribe their own treatment in the form of various antibacterial drugs, as well as instillation of aloe juice into the nose, which is not necessary. It is especially important among citizens to rinse the nasal cavity under pressure, add salt, soda and iodine to the rinsing water, which burns out the mucous membrane, and also contributes to edema and chronicity of the process, ”she complains and notes that one of the options for preventing the development or exacerbation of sinusitis is timely diagnosis and correction of disturbances in the structure of the nasal cavity.If antibiotics are prescribed by a specialist for chronic rhinosinusitis, then immediately for a long period – up to three months, Kirichenko points out.
In her opinion, with an exacerbation of chronic rhinosinusitis, the prescription of antibiotics is generally not always justified. However, for patients with complications in the form of chronic immunodeficiency, diabetes mellitus, HIV infection, hepatitis B or C, as well as with immunosuppressive therapy, the appointment of antibiotic therapy against the background of exacerbation of chronic sinusitis will be justified.The appointment of antibiotics can also take place with odontogenic sinusitis, which often proceeds with complications and requires treatment not only by an ENT doctor, but also by a dentist.
“Depending on the clinical picture, the doctor himself decides whether or not to prescribe antibiotic therapy, but incorrectly prescribed antibiotic therapy can lead to an increase in resistance. Therefore, indiscriminate prescription of antibiotics in the treatment of chronic rhinosinusitis is not recommended, ”Kirichenko warns.
The ancestor of all antibiotics – penicillin – was discovered in 1928 by the British bacteriologist Alexander Fleming. The find that changed the course of history was accidental. Dr. Fleming was not very neat: his laboratory was often a mess, and Petri dishes, which are used in laboratories to culture and monitor bacteria and viruses, often remained unwashed after experiments. Fleming examined colonies of staphylococci. Once, after another study, he went on vacation for a month, leaving the cups unwashed by tradition, and when he arrived, he found mold in them.As a real researcher, he decided not to wash the cup, but to examine the mold under a microscope. What he saw surprised him: there were no bacteria around the mold. Fleming concluded that this type of mold suppresses pathogens. The molds in the cup belonged to the genus Penicillum – and the substance that had an antibacterial effect was called penicillin. This drug has saved millions of lives.
And today, the role of antibiotics in the modern world should not be underestimated.Some diseases simply cannot be cured without them. “With the help of antimicrobial drugs, complex, almost fatal pathologies, including pneumonia, meningococcal infections, are successfully cured,” says therapist, immunologist Lyudmila Vasilenko. The harm of antibiotics to the body is also obvious. Their impact is manifested not only in interference with the vital activity of pathogenic microbes, but also in the total elimination of beneficial microflora, primarily the intestines, which is fundamental for maintaining the immune system.
“Experts consider the irritation of the mucous membrane of the stomach and intestines, a complex imbalance of the microflora of the gastrointestinal tract, disruption of the kidneys, liver and gall bladder, expressed by an allergic reaction, and a disorder of the nervous system manifested in vestibular disorders. Recently, cases of uncontrolled use of antibacterial drugs by patients spontaneously have become more frequent. Statistics show that these are mostly people who are busy with their careers and do not have the opportunity to visit a doctor and adjust the treatment regimen, ”complains Lyudmila Vasilenko.
“When treating viral infections, antibiotics are prescribed only if the disease is complicated by a bacterial infection and the harm of antibiotics is comparable to the benefit for the whole organism,” emphasizes Lyudmila Vasilenko. Doctors also say there is a rule of thumb to take antibiotics safely. In order for antibiotic treatment to be as effective as possible and not to provoke complications, it is necessary, firstly, to observe the dosage prescribed by the doctor. Secondly, before taking it, you should additionally study the instructions: in the list of contraindications, there may be pathologies that the attending doctor did not take into account.Thirdly, you should not practice taking antibacterial drugs on an empty stomach, since the harm of antibiotics to the mucous membrane of the stomach and intestines is a long-proven fact. In addition, the medicine should be taken with a sufficient amount of water: this will minimize the effect on the mucous membrane. Alcohol, absorption of absorbents, blood thinners are excluded for the entire period of antibiotic therapy. “Against the background of the improvement of the condition and the removal of the symptoms of pathology, one should not arbitrarily stop taking the medicine, since the bacteria that have not been completely killed will develop resistance to the drug and further treatment will be ineffective.The harm of antibiotics is minimized by taking probiotics. Doctors prescribe to patients a regimen according to which these drugs should be taken for the entire period of treatment and for some time after the end of therapy. Since an antibacterial agent can suppress the immune system, do not forget about taking immunomodulators and vitamin complexes, ”recommends Lyubov Vasilenko.
Antibiotics effectively neutralize many types of bacteria, but not all. Some strains survived the treatment and multiply, because of this, in the future, the effectiveness of antibacterial drugs decreases.That is why scientists have to develop more and more antibiotics.
The European Antimicrobial Consumption Control Network has identified the spread of antibiotic-resistant bacteria as a public health threat and urged the scientific community to continually develop new drugs. “New generation antibiotics have a broader spectrum of action. The effectiveness of modern antibacterial agents is growing, their side effects are decreasing. But it is worth remembering that due to the rapid growth of resistance to modern antibiotics, the production of an effective new generation drug can take decades, ”complained therapist Vladislav Zhemchugov.
90,000 how to remove toxins after antibiotics
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The disadvantages include a long, in comparison with synthetic drugs, course of treatment and some inconveniences of taking Klinistil ampoules, in comparison with tablets.
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That is why, after taking antibiotics, you need to help your body recover.Restoration of intestinal microflora and immunity. Long-term use of antibiotics significantly worsens the intestinal microflora. One of the most common results of such dysbiosis after taking antibiotics is candidiasis. Its symptoms: the appearance of atypical discharge, which differ in density, consistency, color and odor, itching, burning and irritation. An accurate diagnosis can only be made by a doctor, but due to the prevailing unfavorable epidemiological situation, the buyer can turn to a pharmacist for a recommendation and purchase of over-the-counter drugs.Why does diarrhea occur after taking antibiotics? The mechanism of diarrhea development after a course of antibiotics. Treatment of antibiotic-associated diarrhea. Prevention of diarrhea with antibiotic therapy. When to see a doctor .. Antibiotics are a group of medicines aimed at fighting disease-causing bacteria. Once in the body, they suppress the growth of pathogenic flora and contribute to the elimination of infectious and inflammatory diseases .. elimination of toxins and metabolic products; excretion, absorption of water in the intestine; the formation of feces, the regulation of their excretion.After antibiotic therapy, a group of penicillin fungi settle in the intestines and liver, as well as in the blood and lymph. They inhibit the normal intestinal microflora and reduce immunity, allergize all mucous membranes of the body. And against this background, there may be various manifestations of allergies, both to medicines and to various foods. As well as increased susceptibility to various viruses, bacteria, parasites .. The bone marrow, which produces blood elements, is exposed to a large toxic load when using antibiotics.The blood formula often changes, which can lead to cancer of the blood. Reproductive function is impaired. The discovery of antibiotics has become a kind of milestone in the development of not only medicine, but society as a whole. Such effective drugs, of course, naturally have side effects. However, the benefits of antibacterial agents are so pronounced that their use, despite the high prevalence of side effects, will not stop. Among the side effects of almost all antibiotics, the most common is indigestion in the form of stool disorder, the occurrence of antibiotic-associated diarrhea.Moreover, in recent years, the incidence of antibiotic-associated diarrhea has increased. after taking antibiotics to restore microflora. Non-pathogenic live microorganisms support the synthesis of interferon, relieving allergy symptoms. The active ingredients neutralize the Helicobacter Pylori bacteria, which cause gastric ulcer. The active substances included in Linex are resistant to antibiotics. They affect not only the lower intestines, but also the upper ones (not all probiotics have these properties).A multicomponent product suitable for almost all patients, including children (even those who are on artificial nutrition). Intestinal detoxification. In order for the normal flora to grow and multiply well, you need to remove toxins from the body. In combination with probiotics, you can use prebiotics, for example Narine-forte with inulin. Inulin is a soluble fiber that is not digested in the intestines. Together with a large number of bacterial cell components, it acts as a natural sorbent.Thus, the body is cleansed of toxins accumulated during the illness. Stage III. Creation of a temporary artificial biocenosis in the intestine. Drugs that are poorly absorbed from the gastrointestinal tract are excreted by the intestines and are used for gastritis, enteritis and colitis (for example, astringents, some antibiotics used for intestinal infections). In addition, drugs and their metabolites from the liver cells enter bile and enter the intestine with it, from where they are either reabsorbed, delivered to the liver, and then with bile into the intestine (intestinal-hepatic circulation), or are excreted from the body with feces.Intestinal antibiotics. Most intestinal infections have been proven to be caused by gram-negative bacteria. For this reason, antibiotics that are active against gram-negative microflora have the maximum antibacterial effect. The well-known antibiotic Levomycetin disrupts the production of protein structures of bacterial cells and inhibits their enzymatic activity. However, with intestinal infections, it is used only in case of severe systemic disorders, since the substance quickly enters the bloodstream and passes through all barriers.The drug is prescribed in case of insufficient action of local antibiotics. If you don’t have a rash, indigestion, or other symptoms after taking antibiotics, this does not mean that the side effects have passed you by. It’s just that the body silently took the blow and did not show it. Antibiotics are inside us .. The organ, which is supposed to cleanse the blood of toxins, does not cope well with its function, as a result of which the body suffers from intoxication. How to help the body to recover? These include the complex with liquid coal pectin, which not only removes harmful substances, but also restores the intestinal microflora.The main active ingredient in Liquid Charcoal is apple pectin. It dissolves in water and turns into a gel. After taking antibiotics, these bacteria die, opening the way for other microorganisms that emit gases and other toxic substances and prevent water absorption. From all this, a typical complex of symptoms is formed – frequent diarrhea, flatulence, bloating and abdominal pain, symptoms of general intoxication (weakness, fatigue, sometimes a slight increase in temperature). There is only one way to eliminate such consequences of antibiotic treatment – by taking probiotic preparations containing live bacteria that are useful for our body (Linex, Bifidumbacterin).In mild cases, it is enough.
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The drug Klinistil has a natural composition and a convenient form, so you can use it yourself, but the instructions for use recommend that you first consider the principles of use.It is advisable to consult a doctor who will select the appropriate treatment regimen for each patient. When pains, digestive problems, nausea and vomiting appeared, the sister recommended drinking Klinistil ampoules. She is a physician, suggested that helminthiasis. My sister gave one package, and bought 2 more on the manufacturer’s website. I spent the course on drink, the problems disappeared. Klinistil does not contain alkaloids. When the bioactive substances of the components of drugs are broken down, alkaloids are not formed – there is no addictive effect, regardless of the duration of the course and the daily dosage.