A colleague of mine is a nervous traveler, and when she travels to developing countries (every two months or so), she takes antibiotics prophylactically to prevent possible gastrointestinal problems from the local water, food etc. I am not a big fan of drugs generally, and this seems like a bad idea to me. But I was wondering whether there was any evidence on this? Would taking antibiotics so regularly lead to reduced effectiveness in the person over time? Would it contribute to bacterial resistance (either in the individual or in the population more generally)? Could it lead to sensitivity or allergy?
And would this even work? Will antibiotics taken before exposure stop the infection from the pathogen in question?
Straight Dope appreciated!
(oh, I should add that she says she always takes the complete course of treatment)
I remember getting ready for dental surgery I was given a pretreatment of antibiotics - so it does seem to work and is used if one is potentially going to be exposed - at least in my case.
Also I think the resistant bacteria are going to be the ones already inside her body that survived the rounds of antibiotics. Not so much the new bacteria, which should have a very difficult time getting a foothold if the body has antibiotics already in it. The resistance from what I remember is more when people already sick take antibiotics but either miss too many doses or discontinue their use before the bacteria are exterminated, the surviving bacteria now are the ones that reproduce, sio the following generations are the more resistant type.
As an actual denzian of the Third World I can tell you that just simply take regular precautions, eat cooked food, use boiled or bottle water, prefer hot beverages to cold ones, nd she should be fine.
Even then, the majority of people fall ill, not due to bad pathogens, but unfamiliar ones, that you don’t have immunity to, but the locals do. Which is why you can fall ill in a different city in your own country. I have fallen ill three of the last four times I visited the US.
A friend of mine is a gastroenterologist and she tends to say the best thing you can do is wash your hands regularly, I remember sitting with her once seeing a “how to stay healthy” episode on some holiday show and she basically said that this is better than anything else.
Isn’t gastrointestinal problems a side effect of antibiotics? You kill of the flora of your gut, and it goes somewhat hay-wire. All she’s doing is giving the new bacteria an easier battle!
If dentists do work on an actively infected tooth, they like to treat it with antibiotics for a week, I think (not sure) to prevent spilling all the infection all over in your mouth. But most dental work doesn’t involve an ongoing infection like that.
If she travels that much in the third world, she probably already has a natural immunity to nearly all the pathogens she is likely to encounter that way. I do. I drink tap water everywhere and eat in street market stalls, and I never get sick.
One of the main reasons farmers feed antibiotics to livestock is it makes them gain weight, probably by affecting their digestive systems.
There’s no reason to think that it’s any different in humans. Besides weight gain and obesity, antibiotics may possibly be linked to gluten and lactose intolerance and other digestive disorders.
I really wouldn’t take antibiotics unnecessarily. Your colleague may end up regretting it when it’s too late, and the benefits for traveling are probably minimal.
so it sounds like there are no clear risks, though there are some possible secondary effects related to antibiotics in general.
But what about developing allergies? As a kid I had frequent ear infections (every few months if I recall) and took penicillin quite often. As a teenager I became allergic to penicillin, and we always suspected that was a result of the frequent doses as a kid. Could that happen with my colleague?
In addition to allergic reactions, Stevens-Johnson Syndrome (mentioned upthread in spoiler), and altering gut flora, there is a risk of C. difficile colitis (aka pseudomembranous colitis aka antibiotic-related colitis), which is basically a severe consequence of altering gut flora.
And of course there is the 100% risk of cost of antiobiotic (which I guess your friend accepts in hopes of decreasing risk of traveler’s enteritis).
Prophylactic antibiotics (using antibiotics *before *an infection occurs) is a time honored practice. By that I mean, doctors have been doing it for a long time. They do it for the same reasons the OP’s friend does, because it makes so much darn intuitive sense. Sometimes studies support the practice, sometimes they don’t, but it’s a hard practice to give up.
Here is a sample of recommendations in current medical practice.
Dentist have often prescribed a round prior to dental work in selected patients (those with bad heart valves and such), because bacteria will frequently enter the bloodstream during dental procedures; AFAIK, this is being cut back in formal recommendations, whereas previously they might be recommended even for teeth cleaning.
Current recommendations don’t recommend prophylactic antibiotics for traveler’s diarrhea (TD) for most people, although they do suggest taking something along to treat (and shorten the symptoms) TD after it starts…
prophylactic antibiotics are taken before you have symptoms (or often even exposure).
empiric treatment is treatment based on symptoms (that is without knowing the specific cause); in this case, they mean carrying along a treatment course good for bugs expected where you are going and starting treatment shortly after symptoms begin
I recall another problem of antibiotics - which of course I have no first hand knowledge - is that they can kill beneficial bacteria and result in a greater risk of vaginal yeast infections.
Research shows that adults are 3 times more likely to contract drug-resistant infections in the three months after being prescribed antibiotics, and children 12 times more likely.
Just in case you didn’t know … you can get gastrointestinal problems at home too or on an airline or one time I ate at a open salad bar at Wendy’s and it all came back up, yuck!
But even your own refrigerator has hidden problems … like never cut an onion in half and then place the unused portion back in the refrigerator. The onion will draw all of the bacteria in the fridge into the onion. People think that when they get food poisoned that it was the mayo or something, but in reality it was the onions in the old stuffing or potato salad.
How long does it take for your body to get back to normal after taking antibiotics?
