BBC - MEDICAL MYTHS|
17 September 2013 |Claudia Hammond
Studies show booze won’t stop
most treatments from working properly or cause unpleasant side-effects.
However, the story isn’t quite that simple.
Women who are in the early stages of pregnancy, and who are not ready
to share the happy news, know that turning down an alcoholic drink at a social
occasion can be a dead giveaway. Telling friends and colleagues they are on
antibiotics is the perfect excuse because they are so commonly used. Even the
nosiest of acquaintances is unlikely to ask what they are being taken for.
But is it really true that you need to abstain from alcohol when on a
course of antibiotics?
Some people assume that alcohol will stop antibiotics from working
properly, while others believe that it will cause side-effects. When staff in a
London genitourinary clinic surveyed more than 300 patients they found that 81%
believed the former assumption, with 71% believing the latter.
For most antibiotics neither of these assumptions is true. The fear for
doctors is that these erroneous beliefs might make patients skip their
medication over a glass of wine. Anything that encourages people to miss doses
of antibiotics adds to the serious problem of antibiotic resistance.
In fact, the majority of the most commonly prescribed antibiotics are
not affected by alcohol. There are some exceptions. The antibiotics cephalosporin cefotetan and cephalosporin
ceftriaxone slow alcohol breakdown, leading to a rise in levels of a
substance called acetaldehyde. This can cause a host of unpleasant symptoms
including nausea, vomiting, facial flushing, headache, breathlessness and chest
pain. Similar symptoms are caused by a drug called disulfiram, sometimes used in the treatment for alcohol dependency.
The idea is that the moment a patient has a drink, they experience these
unpleasant symptoms, and this dissuades them from drinking more. The symptoms
are unpleasant, so it is important that people abstain from alcohol while they’re
taking these particular antibiotics, and for a few days afterwards.
Another type of antibiotic that comes with a specific warning not to
take alongside alcohol is metronidazole.
Used to treat dental infections, infected leg ulcers and pressure sores, it’s
thought to cause the same list of symptoms as the previously mentioned
cephalosporins. This link has been disputed since a 2003 review of studies
found a lack of evidence to support it, and a very small controlled study in
which Finnish men given metronidazole for five days suffered no side effects
when they consumed alcohol. The authors concede that this doesn’t rule out the
possibility that a few individuals are affected, and the current advice is
still to avoid alcohol when taking it.
There are a few other antibiotics for which there are good reasons to
avoid drinking alcohol while taking them, including tinidazole, linezolid and erythromycin, but these interactions are
so well-known that doctors give patients specific warnings.
Recycled tale
This leaves a long list of other antibiotics that can be mixed with
alcohol. Of course getting drunk is not going to help your recovery when you’re
ill. It can make you tired and dehydrated, but it’s not because of any
interaction with your medication.
It’s possible that the isolated cases led to the myth that all
antibiotics don’t mix with alcoholic drinks, but there are two more intriguing
theories. One is that because antibiotics are used to treat some of the most
common sexually transmitted diseases, doctors in the past were somehow
punishing the patients for becoming infected by depriving them of their
favourite tipple.
Or there’s the explanation given to one of the authors of the London
genitourinary clinic survey. James Bingham met the late Brigadier Sir Ian
Fraser, who introduced the use of penicillin for injured soldiers in North
Africa during World War II. At the time penicillin was in such short supply
that after a patient had taken it, the drug was retrieved from his urine and
recycled. Recuperating soldiers were allowed to drink beer, but unfortunately
this increased the volume of their urine, making it harder obtain the
penicillin and, according to the Brigadier, led commanding officers to ban
beer.
It's a good story, irrespective of whether or not it is the true source
of the popular misconception. Dispelling the myth is something of a
double-edged sword. Encouraging those on the antibiotics who cannot resist a
glass or two to complete their courses of treatment could help counter the
spread of antibiotic resistance. However greater public understanding of the
true picture may mean that women wanting to keep their early pregnancies to
themselves in social situations may have to be a little more inventive in
future.
Source: http://www.bbc.com/future/story/20130917-truth-about-drink-and-antibiotics/all
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