# Impacts of regular use of antibiotics? **URL:** \ **Category:** Factual Questions\ **Created:** [November 28, 2016, 1:47pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274 "2016-11-28T13:47:46Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Orville\_mogul](https://avatars.discourse-cdn.com/v4/letter/o/aeb1de/32.png) [@Orville\_mogul](https://boards.straightdope.com/u/Orville_mogul)\ **Post date:** [November 28, 2016, 1:47pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/1 "2016-11-28T13:47:46Z")
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) ---
**Author:** ![SmartAlecCat](https://avatars.discourse-cdn.com/v4/letter/s/67e7ee/32.png) [@SmartAlecCat](https://boards.straightdope.com/u/SmartAlecCat)\ **Post date:** [November 28, 2016, 2:21pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/2 "2016-11-28T14:21:00Z")
One thing to be aware of – Antibiotic use can affect the effectiveness of estrogen based birth control pills. ---
**Author:** ![kanicbird](https://avatars.discourse-cdn.com/v4/letter/k/5f8ce5/32.png) [@kanicbird](https://boards.straightdope.com/u/kanicbird)\ **Post date:** [November 28, 2016, 2:26pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/3 "2016-11-28T14:26:06Z")
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. ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [November 28, 2016, 2:53pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/4 "2016-11-28T14:53:49Z")
> [@Orville\_mogul](#): > > 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) [Moderator Note - link spoilered due to gruesome image content] [Steven Johnson syndrome](https://en.wikipedia.org/wiki/Stevens%E2%80%93Johnson_syndrome) 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. ---
**Author:** ![naita](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/naita/32/5862_2.png) [@naita](https://boards.straightdope.com/u/naita)\ **Post date:** [November 28, 2016, 3:00pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/5 "2016-11-28T15:00:26Z")
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! ---
**Author:** ![Orville\_mogul](https://avatars.discourse-cdn.com/v4/letter/o/aeb1de/32.png) [@Orville\_mogul](https://boards.straightdope.com/u/Orville_mogul)\ **Post date:** [November 28, 2016, 4:14pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/6 "2016-11-28T16:14:16Z")
> [@SmartAlecCat](#): > > One thing to be aware of – Antibiotic use can affect the effectiveness of estrogen based birth control pills. Hmm, I wonder how I might raise that particular point with her without getting a call from HR 😃 ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [November 28, 2016, 6:19pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/7 "2016-11-28T18:19:15Z")
> [@naita](#): > > 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! Yes, your gut biome is destroyed. This can be ameliorated by probiotics to some degree. ---
**Author:** ![jtur88](https://avatars.discourse-cdn.com/v4/letter/j/e9c0ed/32.png) [@jtur88](https://boards.straightdope.com/u/jtur88)\ **Post date:** [November 28, 2016, 7:12pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/8 "2016-11-28T19:12:41Z")
> [@kanicbird](#): > > 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. 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. > [@Orville\_mogul](#): > > 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. 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. ---
**Author:** ![GreenWyvern](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/greenwyvern/32/2834_2.png) [@GreenWyvern](https://boards.straightdope.com/u/GreenWyvern)\ **Post date:** [November 28, 2016, 7:13pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/9 "2016-11-28T19:13:42Z")
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. ---
**Author:** ![Orville\_mogul](https://avatars.discourse-cdn.com/v4/letter/o/aeb1de/32.png) [@Orville\_mogul](https://boards.straightdope.com/u/Orville_mogul)\ **Post date:** [November 29, 2016, 12:43pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/10 "2016-11-29T12:43:46Z")
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? ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [November 29, 2016, 4:56pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/11 "2016-11-29T16:56:14Z")
Actually, there are clear risks. 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. > **[Antimicrobial Prophylaxis in Adults](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127564/)** > > Antimicrobial prophylaxis is commonly used by clinicians for the prevention of numerous infectious diseases, including herpes simplex infection, rheumatic fever, recurrent cellulitis, meningococcal disease, recurrent uncomplicated urinary tract... 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… [http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/travelers-diarrhea](http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/travelers-diarrhea) > [@](#): > > At this time, prophylactic antibiotics should not be recommended for most travelers. Prophylactic antibiotics afford no protection against nonbacterial pathogens and can remove normally protective microflora from the bowel, which could make a traveler more susceptible to infection with resistant bacterial pathogens. A traveler relying on prophylactic antibiotics will need to carry an alternative antibiotic to use in case diarrhea develops despite prophylaxis. Additionally, the use of antibiotics may be associated with allergic or adverse reactions in a certain percentage of travelers and may potentially contribute to drug resistance. The use of prophylactic antibiotics should be weighed against the result of using prompt, early self-treatment with antibiotics when TD occurs, which can limit the duration of illness to 6–24 hours in most cases. Prophylactic antibiotics may be considered for short-term travelers who are high-risk hosts (such as those who are immunosuppressed) or who are taking critical trips (such as engaging in a sporting event) during which even a short bout of diarrhea could affect the trip. > **[Traveler’s Diarrhea](https://www.aafp.org/pubs/afp/issues/2005/0601/p2095.html)** > > Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli,... > [@](#): > > Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of traveler’s diarrhea. Parasites and viruses are less common etiologies. Travel destination is the most significant risk factor for traveler’s diarrhea. The efficacy of pretravel counseling and dietary precautions in reducing the incidence of diarrhea is unproven. Empiric treatment of traveler’s diarrhea with antibiotics and loperamide is effective and often limits symptoms to one day. Rifaximin, a recently approved antibiotic, can be used for the treatment of traveler’s diarrhea in regions where noninvasive E. coli is the predominant pathogen. In areas where invasive organisms such as Campylobacter and Shigella are common, fluoroquinolones remain the drug of choice. Azithromycin is recommended in areas with quinolone-resistant Campylobacter and for the treatment of children and pregnant women. ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [November 29, 2016, 5:24pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/12 "2016-11-29T17:24:44Z")
just to clarify that last quote: 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 ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [November 29, 2016, 5:38pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/13 "2016-11-29T17:38:01Z")
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. ---
**Author:** ![Blue\_Blistering\_Barnacle](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/blue_blistering_barnacle/32/3386_2.png) [@Blue\_Blistering\_Barnacle](https://boards.straightdope.com/u/Blue_Blistering_Barnacle)\ **Post date:** [November 29, 2016, 5:54pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/14 "2016-11-29T17:54:40Z")
Yes, absolutely. And of course any infection you do come down with (anywhere) is likely to be resistant to the drug you are taking. ---
**Author:** ![GreenWyvern](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/greenwyvern/32/2834_2.png) [@GreenWyvern](https://boards.straightdope.com/u/GreenWyvern)\ **Post date:** [November 30, 2016, 7:21pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/15 "2016-11-30T19:21:10Z")
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. > [@](#): > > Paul Cosford, medical director at Public Health England, told MPs on Wednesday that children are 12 times more likely to contract drug-resistant infections in the three months after being prescribed antibiotics, suggesting that their unnecessary use poses a direct risk to individual patients as well as a broader threat to society as a whole. > > “We’ve got good evidence that if you or I have a course of antibiotics now, within three months our risk is three times to get a resistant infection of some sort because we’ve had the antibiotics affecting all the organisms in our bodies,” he told the Science and Technology Select Committee. “If you’re a child you’re 12 times more likely to get a resistant infection in the three months after a course of antibiotics.” > > He said the figures, based on two major reviews, highlighted the need to continue driving down our reliance on the drugs. “There is a growing body of evidence that taking antibiotics makes it more likely that your next infection will be a resistant one, so prudent use of these life-saving medicines is essential,” he told the Guardian. > **[Antibiotics leave children 'more likely to contract drug-resistant infections'](https://www.theguardian.com/society/2016/nov/30/antibiotics-leave-children-more-likely-to-contract-drug-resistant-infections)** > > Public health official warns children’s risk of drug-resistant infections 12 times higher in months following course of antibiotics ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [November 30, 2016, 8:01pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/16 "2016-11-30T20:01:16Z")
I never use antibiotics unless strongly recommended by a physician. Overuse of antibiotics and underuse of vaccines are the twin tragedies of modern the modern age… (Says this former microbiologist). ---
**Author:** ![Mr\_Quatro](https://avatars.discourse-cdn.com/v4/letter/m/bc8723/32.png) [@Mr\_Quatro](https://boards.straightdope.com/u/Mr_Quatro)\ **Post date:** [November 30, 2016, 9:26pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/17 "2016-11-30T21:26:19Z")
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? ---
**Author:** ![buddha\_david](https://avatars.discourse-cdn.com/v4/letter/b/ee7513/32.png) [@buddha\_david](https://boards.straightdope.com/u/buddha_david)\ **Post date:** [November 30, 2016, 9:34pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/18 "2016-11-30T21:34:23Z")
> [@Blue\_Blistering\_Barnacle](#): > > …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 if that doesn’t dissuade her, tell her the standard treatment for c.diff is to [drink a fecal milkshake.](http://www.stuffyoushouldknow.com/podcasts/fecal-transplants-gonna-drink-poop.htm) :eek: ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [November 30, 2016, 11:47pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/19 "2016-11-30T23:47:21Z")
> [@Mr\_Quatro](#): > > Q > 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. I was going to ask for a cite, but unless you can beat [Snopes](http://www.snopes.com/food/tainted/cutonions.asp), I think this is an urban legend or superstition… ---
**Author:** ![Darren\_Garrison](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/darren_garrison/32/92_2.png) [@Darren\_Garrison](https://boards.straightdope.com/u/Darren_Garrison)\ **Post date:** [November 30, 2016, 11:53pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/20 "2016-11-30T23:53:54Z")
> [@buddha\_david](#): > > And if that doesn’t dissuade her, tell her the standard treatment for c.diff is to [drink a fecal milkshake.](http://www.stuffyoushouldknow.com/podcasts/fecal-transplants-gonna-drink-poop.htm) :eek: Still easier than swallowing a wolf. [Next page](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274.md?page=2)