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Milk and antibiotics amoxicillin: Using medication: Using antibiotics correctly and avoiding resistance – InformedHealth.org

Using medication: Using antibiotics correctly and avoiding resistance – InformedHealth.org

Created: November 14, 2008; Last Update: December 18, 2013; Next update: 2020.

The development of antibiotics was one of the great discoveries in modern medicine. They fight bacteria and can cure life-threatening infectious diseases such as pneumonia, for which there was previously no effective treatment. But the improper use of antibiotics means that more and more bacteria are becoming resistant to this kind of medication. So it is especially important to use them correctly.

Antibiotics can save lives, but they also relieve symptoms of bacterial infections and help us recover faster. But treatment with antibiotics also has side effects. Nausea or diarrhea are common, for example.

Antibiotics are also used far too often, and improper use is widespread. This has caused many different types of bacteria to become resistant (unresponsive) to antibiotics. Because resistance has become more common, many diseases cannot be treated as well as they could in the past.

When using antibiotics, it’s important to know the following things to prevent resistance and side effects:

  • Antibiotics only work against bacteria. Many infections are caused by viruses and can’t be treated using antibiotics – examples include respiratory illnesses such as a cough, stuffy nose, bronchitis or the flu.

  • Excessive and improper use of antibiotics causes side effects, and in the long term reduces their effectiveness.

What is antibiotic resistance?

In medicine, bacteria and other germs are said to be resistant if they are especially able to withstand exposure to external influences. For example, most germs that enter the stomach with food will be killed by stomach (gastric) acid. But some bacteria are covered with a mucous coating that protects them from the acid. They are resistant to gastric acid.

Resistance to antibiotics works on a similar principle: The bacteria have acquired a new property that protects them from the antibiotic. Some types of bacteria can produce a substance that makes certain antibiotics ineffective, for example. Bacteria that can protect themselves from several different antibiotics are referred to as “multiresistant.”

What causes resistance?

Many of the bacteria that are now resistant used to be sensitive to antibiotics. There are a few developments that played a role in this. To put it briefly, one kind of antibiotic could originally neutralize a certain type of bacteria and then effectively stop the infection. But the genetic material of bacteria can change by chance, sometimes creating new properties. If they protect the bacteria from an antibiotic, then the bacteria have become resistant. These kinds of properties can also transfer from one type of bacteria to another.

If antibiotics are used very often, resistant bacteria are better able to reproduce because the other non-resistant strains of bacteria are stopped. Antibiotics then no longer help against infections caused by resistant bacteria.

Which bacteria are resistant to antibiotics and why are they dangerous?

Strains of Streptococcus and Staphylococcus bacteria are often resistant to antibiotics. One example is called “methicillin-resistant Staphylococcus aureus” (MRSA). Staphylococci can be found on skin and mucous membranes and may cause infection – for example if they get into open wounds.

Resistant strains have now developed in other types of bacteria, such as Escherichia coli, Klebsiella and pseudomonads.

What is being done about antibiotic resistance?

In Germany, antibiotics are prescription-only. This means that doctors are first and foremost responsible for careful and appropriate use. They are to first see whether someone actually has a bacterial infection. If they do, then it’s important that the antibiotic is prescribed at the right dose and for long enough, and that the right antibiotic is selected that will most effectively fight the bacteria.

There are also hygiene regulations to keep resistant bacteria from spreading further and preventable infections from occurring. These measures are especially important inside of a hospital. Antibiotics are used there relatively frequently, so resistant germs can develop quite quickly. If you come into contact with someone who has an infection of resistant bacteria, it can help to wear disposable gloves, a mask and coat, and to use a hand disinfectant to stop the spread of the germs.

Antibiotics are also used in veterinary medicine and in agriculture. Veterinarians also have to comply with the rules for handling antibiotics properly.

What can I do to prevent antibiotic resistance?

Being cautious when taking antibiotics can help prevent both antibiotic resistance and side effects.

The most important thing is to not overestimate what antibiotics can do: Patients often expect antibiotics to be prescribed to treat medical conditions for which they are not suitable.

Antibiotics are needed to treat serious bacterial infections like lung infections or meningitis (inflammation of the membranes lining the brain and spinal cord). This is not the case when, for example, people who are otherwise healthy have respiratory infections caused by viruses, such as a cold or influenza (“the flu”). Antibiotics will usually be of no help because they only fight bacteria. Antibiotics also have side effects including allergic reactions, stomach and bowel problems, nausea and fungal infections. Because of these associated risks, it’s important to carefully consider the advantages and disadvantages of taking antibiotics.

What’s important to consider when taking antibiotics?

Antibiotics should be taken for as long as the doctor has prescribed them. Just because the symptoms of the illness subside, it doesn’t mean that all of the germs have been killed. Remaining bacteria may cause the illness to start up again.

If there are some tablets left over, they should not be kept for later use or given to other people. Leftover medication can be disposed of in the normal garbage or dropped off at some pharmacies. Pharmacies are not obligated to accept opened medicine though. It is important not to dispose of the medication by pouring it down the drain or flushing it down the toilet. That is bad for the environment and also contributes to bacterial resistance.

Medications can only work properly if they are used correctly. It’s important to know the following things when taking antibiotics:

  • Can the tablets be broken into smaller pieces to make them easier to swallow? Doing this can stop some medications from working properly.

  • What food can you take antibiotics with? Antibiotics are usually taken with water because taking them together with fruit juices, dairy products or alcohol can affect how the body absorbs some drugs. Dairy products include milk as well as butter, yogurt, and cheese. After taking an antibiotic you may need to wait for up to three hours before eating or drinking any dairy products. Grapefruit juice and dietary supplements containing minerals like calcium may also work dampen the effect of antibiotics.

  • When should you take antibiotics? Some antibiotics are always meant to be taken at the same time of day, others are meant to be taken before, with or after a meal. If you are supposed to take the medicine three times a day, for example, it usually needs to be taken at set times so that the effect is spread out evenly over the course of the day. You could remember the regular times of 6 a.m., 2 p.m. and 10 p.m. for an antibiotic that needs to be taken every 8 hours, for example.

  • Can you take antibiotics together with other medications? Because antibiotics can interact with other medications, it’s important to tell your doctor if you take other medications too. Antibiotics might interact with some blood thinners and antacids, for example. Some antibiotics can make birth control pills less effective.

You can find detailed information on the use of a specific antibiotic in the package insert. If you’re not sure about what is important to consider when taking the antibiotic, you can ask your doctor or pharmacist.


  • Bundesministerium für Gesundheit (BMG), Bundesministerium für Ernährung und Landwirtschaft (BMEL), Bundesministerium für Bildung und Forschung (BMBF). DART 2020. Zwischenbericht anlässlich der WHA 2016. May 2016.

  • Centers for Disease Control and Prevention (CDC). Antibiotic / Antimicrobial Resistance. June 12, 2017.

  • Deutsche Gesellschaft für Infektiologie e.V. (DGI). S3-Leitlinie: Strategien zur Sicherung rationaler Antibiotika-Anwendung im Krankenhaus. AWMF-Register-Nr.: 092-001. December 15, 2013.

  • Kayser FH, Böttger EC, Deplazes P, Haller O, Roers A. Taschenlehrbuch Medizinische Mikrobiologie. Stuttgart: Thieme; 2014.

  • Weltgesundheitsorganisation (WHO). Antimicrobial resistance. October 2016.

  • IQWiG health information is written with the aim of helping
    people understand the advantages and disadvantages of the main treatment options and health
    care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the
    German health care system. The suitability of any of the described options in an individual
    case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a
    team of
    health care professionals, scientists and editors, and reviewed by external experts. You can
    find a detailed description of how our health information is produced and updated in
    our methods.

Does What You Eat Affect Antibiotic Effectiveness?

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By Chloe Bennett, B.Sc.Reviewed by Dr. Jennifer Logan, MD, MPH

The discovery of antibiotics is arguably one of the great modern medical discoveries.

Image Credit: nokwalai/Shutterstock.com

However, the over-prescription and improper use of the potentially life-saving drug has increased antibiotic resistance. However, new research has found that what you eat may affect antibiotic effectiveness.

Cranberries and Antibiotic Effectiveness

The epidemic of antibiotic resistance poses a threat to decades of progress in antibiotic use to fight bacterial infections.

The overprescription and overuse of antibiotics in medicine and agriculture have led many to argue that we may be forced to a pre-antibiotic era whereby the risk of developing even minimal infections could be costly. In light of this, it has become vital to maximizing the effectiveness of current antibiotics used.

Recent research working towards this aim has found that cranberries may boost the overall effectiveness of antibiotics. Specifically, the researchers observed that pathogenic bacteria develop increased sensitivity to lower doses of antibiotics when exposed to molecules found in cranberries. Furthermore, resistance to the antibiotics was reduced.

It’s commonly believed that, aside from their antioxidant properties, cranberry consumption is linked to positive health outcomes such as protecting against urinary tract infections (UTIs).

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This led the researchers to investigate the molecular properties responsible for fighting several types of bacteria, namely, Escherichia coli responsible for gastro-enteritis, Pseudomonas aeruginosa responsible for pneumonia, and Proteus mirabilis responsible for UTIs.

It was found that cranberries increased bacterial sensitivity through two mechanisms. The extract was considered to alter the mechanism typically used by the bacteria to get rid of the antibiotic as well as increasing the permeability of the bacterial cell wall.

This resulted in the antibiotic being able to penetrate the bacteria more easily, and the bacteria struggling to get rid of the drug. This provides evidence as to why the drug appears to be more effective in lower doses.

The researchers suggested that central to this activity are molecules called proanthocyanidins. There are different types of proanthocyanidins and it’s thought that the molecules work together to achieve the effects observed.

Further tests were carried out to investigate whether the same pattern existed in a preliminary animal model: infected insects. Similar effects were established, necessitating further experiments to identify the active molecules involved.

Implications of the Research

The novel research may prove to be extremely useful in combating antibiotic resistance, as, if the results can be replicating in animals and the active molecules identified, then it would mean fewer dosages of antibiotics will be required in veterinary and human medicine. Conversely, the use of these compounds may help ensure that the antibiotics are more effective in their current dosages and administrations.

Considerations When Taking Antibiotics

Several considerations are recommended to be followed when taking antibiotics than can reduce their overall effectiveness in fighting infections alongside the probability of resistance. Different types of antibiotics come with their own set of requirements and guidelines to follow.

Medications and Antibiotics

Like any drug, antibiotics can interact with any other medications taken. Evidence has shown that specific antibiotics such as rifabutin and rifampicin can impair the effectiveness of some contraceptive pills. If prescribed these forms of antibiotics, then additional contraceptive methods are recommended.

Additionally, research has found adverse effects in those taking some forms of antibiotics alongside anticoagulants. Specifically, cephalosporins have been found to increase the risk of bleeding if taken in addition to blood-thinning drugs such as warfarin.

Food and Drink Interactions with Antibiotics

In general, alcohol should not be consumed while taking antibiotics. Even alcohol in moderation can cause interactions with antibiotics if consumed within 48 hours of each other.

Certain antibiotics such as tinidazole and metronidazole can cause side effects such as headaches, stomachache, nausea and vomiting, and hot flushes if taken with alcohol.

Similarly, it’s recommended that antibiotics are not taken with fruit juices or dairy products, as they can affect the body’s ability to absorb the medication. Instead, it is recommended that the drug is taken with water only.

Furthermore, the influence of dairy consumption on the effectiveness of antibiotics has been researched. It’s recommended that dairy products such as cheese, milk, butter, and yogurt should not be consumed until 3 hours after a dose of antibiotics is taken.

Likewise, juices or supplements containing calcium may also reduce effectiveness. Antibiotics should come with patient education material that gives specific guidance on which foods to avoid and how to take antibiotics.

In some countries, antibiotics can be purchased without a prescription. Antibiotic use in these areas tends to be high, as patients often self-medicate for conditions that are not helped with antibiotics and the increased presence of antibiotics provides a selective pressure for germs to develop resistance.

Studies show that these areas with higher use have higher rates of antibiotic resistance.


  • Tufenkji, N. et al. (2019) Proanthocyanidin Interferes with Intrinsic Antibiotic Resistance Mechanisms of Gram-Negative Bacteria. Advanced Science. doi.org/10.1002/advs.201802333.
  • NHS (2019). Antibiotics: Interactions. https://www.nhs.uk/conditions/antibiotics/interactions/
  • Institute for Quality and Efficiency in Health Care (2013). Using medication: using antibiotics correctly and avoiding resistance. https://www.ncbi.nlm.nih.gov/books/NBK361005/
  • Farooqui HH, Selvaraj S, Mehta A, Heymann DL. Community level antibiotic utilization in India and its comparison vis-à-vis European countries: Evidence from pharmaceutical sales data. PLoS One. 2018;13(10):e0204805. Published 2018 Oct 17. doi:10.1371/journal.pone.0204805

Last Updated: Nov 17, 2021

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Amoxicillin – Together by St. Jude



Moxatag®, Amoxil®

Other names:


Often used for:


Amoxicillin is an antibiotic. Its action is aimed at the destruction of bacteria that cause infections. Amoxicillin is an antibiotic of the penicillin group. Amoxicillin is available in various dosage forms. Follow dosage instructions carefully.

Oral chewable tablets

Oral capsules

Oral liquid form

  • Diarrhea
  • Nausea and vomiting
  • Headache
  • Abdominal pain
  • Taste disturbance

Symptoms of an allergic reaction may occur: rash, hives, itching, chills, fever, headache, muscle pain, shortness of breath, cough, tightness in the throat, swelling of the face or neck

The listed side effects are not observed in all patients who are prescribed amoxicillin. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • Tell your doctor if you have severe diarrhea while taking this drug.
  • It is important to drink plenty of fluids while taking the drug. Drink the amount of fluid recommended by your doctor.
  • Amoxicillin may interfere with some laboratory tests, especially in patients with high blood sugar (diabetes). Ask your doctor or pharmacist how to properly use the urine glucose test strips and how to interpret the results.
  • Amoxicillin may increase or decrease the effectiveness of other medicines. Tell your doctor or pharmacist about all medicines you are taking, especially if it is methotrexate or probenecid.
  • Pregnant or breastfeeding patients should notify their physician.
  • The use of amoxicillin may reduce the effectiveness of birth control pills and other hormonal methods of contraception. During therapy, patients who are sexually active should use other methods of contraception, such as condoms.
  • The course of taking the drug must be completed completely in accordance with the recommendations of the attending physician or pharmacist.
Taking amoxicillin at home:
  • It should be taken at the same time every day.
  • Long-acting tablets: must be swallowed whole. It is not allowed to break, grind or chew them before taking. The extended-release tablets should be taken within 1 hour after a meal.
  • Amoxicillin in other dosage forms can be taken with or without food. If the drug causes stomach upset, it must be taken with food.
  • In liquid form: shake well before use, use the measuring device provided to measure the dosage. The drug in liquid form can be mixed with milk, juice, water or other cool drinks immediately before taking.
  • Chewable tablet should be chewed or broken before swallowing.
  • Take your dose as soon as possible if you miss it. Do not do this only if there is little time left until the next appointment. In no case do not double the dose at the next dose!
  • Store amoxicillin at room temperature.
  • Liquid amoxicillin may be stored at room temperature or in the refrigerator. After opening, store no more than 14 days.
  • Do not use an expired drug.
  • Follow instructions for safe storage and disposal of the drug.

More about amoxicillin

Is it possible to drink milk if you are taking the antibiotic Amoxicillin? • Blog “Be Healthy!”




Amoxicillin is a synthetic antibiotic from the penicillin group, which is prescribed for the treatment of various bacterial infections. These include diseases such as tonsillitis, bronchitis, pneumonia, otitis media, sinusitis, urinary tract infections, etc.

The use of Amoxicillin allows you to quickly and effectively cope with a bacterial infection. However, a number of formalities should be taken into account when taking this antibiotic. In particular, the combination with food, including milk.


Although there are no contraindications to the use of dairy products in the instructions, their combination may adversely affect the quality of treatment. The fact is that food, including milk, can slow down the absorption of the antibiotic. Thus, less drug enters the blood than is necessary. As a result, the achievement of the desired therapeutic effect is reduced.

But this does not mean that dairy products should be avoided completely. It is only necessary to maintain an interval of 2-3 hours between the intake of any food (including milk) and the drug. You can drink an amoxicillin tablet only with clean water. And you can not drink milk, juices, compotes, etc.

For young children, the medicine should be given to the child between meals. If the child is breast-fed, then the drug is used between feedings. After taking the antibiotic, the child can be given water to drink.


As for fermented milk products, their use is useful in that they can normalize the intestinal microflora disturbed by antibiotics. It will be especially useful to use fermented milk products along with fiber or bran. The use of these products has a beneficial effect not only on the intestinal microflora, but also helps to restore immunity and faster recovery of the body after illnesses.

However, the observance of the time interval in this case is also necessary. Because the joint intake of fermented milk products and an antibiotic leads to a decrease in the therapeutic effect of Amoxicillin. Eating fermented milk products such as kefir, yogurt, fermented baked milk, curdled milk, sour milk is not only possible, but necessary, but 2-3 hours after taking the antibiotic.


The same drug may be manufactured by different pharmaceutical companies under different brand names.