# Impacts of regular use of antibiotics?

**URL:** <https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274>\
**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:** 5\
**Page:** 2

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**Author:** ![si\_blakely](https://avatars.discourse-cdn.com/v4/letter/s/d9b06d/32.png) [@si\_blakely](https://boards.straightdope.com/u/si_blakely)\
**Post date:** [December 1, 2016, 2:03am UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/21 "2016-12-01T02:03:07Z")

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Given that the most common cause of gastroenteritis is viral infection, the antibiotics are not really useful at all.

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**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:** [December 1, 2016, 7:47am UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/22 "2016-12-01T07:47:12Z")

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> [@jasg](#):
>
> 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…

Urban legend! :smack: You calling my mama a liar? :eek:

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**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:** [December 1, 2016, 8:05am UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/23 "2016-12-01T08:05:01Z")

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> [@jasg](#):
>
> 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…

A rather silly urban legend at that. Bacteria are not known for moving a whole lot on their own and with intent.

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**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\
**Post date:** [December 1, 2016, 1:48pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/24 "2016-12-01T13:48:43Z")

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> [@Blue\_Blistering\_Barnacle](#):
>
> 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.

The one I’d be most worried about is C. diff infection, where the organism proliferates in the absence of competing flora killed off by the antibiotics, and can cause grievous symptoms and damage. I’ve seen cases where people had to have total colectomies because of severe C. diff. pseudomembranous colitis.

Antibiotics taken over a long period of time also come with a risk of a variety of side effects. There may also be [systemic effects](http://www.medicalnewstoday.com/articles/289259.php) due to alteration of human metabolic pathways.

I have not seen long-term followup studies on people who take an extended course of antibiotics for “chronic Lyme disease”, but I suspect they are paying a price for non-evidence based treatment of an undocumented ailment.

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**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:** [December 1, 2016, 3:08pm UTC](https://boards.straightdope.com/t/impacts-of-regular-use-of-antibiotics/773274/25 "2016-12-01T15:08:41Z")

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There are also numerous other side effects or toxicities (usually quite rare and/or minor for commonly prescribed antibiotics). We would never be able to list them all in this thread.

For example Cipro and related drugs (fluoroquinolones) have a risk of tendinitis and tendon rupture. Side effects are3 frequently under-reported- I’m guessing that tendinitis is significantly under-reported, but not so much tendon ruptures.

> **[Fluoroquinolone-Associated Tendinopathy: A Critical Review of the Literature](https://academic.oup.com/cid/article/36/11/1404/304264)**
>
> Abstract. With the expanded use of fluoroquinolones for the treatment of community-acquired respiratory infections and reports of tendon injury linked to t

> [@](#):
>
> …The incidence of tendon injury associated with fluoroquinolone use is low in a healthy population but increases in patients who have renal dysfunction, who are undergoing hemodialysis, or who have received renal transplants.
> 
> … tendon injury was reported with most fluoroquinolones. The median duration of fluoroquinolone treatment before the onset of tendon injury was 8 days, although symptoms occurred as early as 2 hours after the first dose and as late as 6 months after treatment was stopped.
> 
> Up to one-half of patients experienced tendon rupture, and almost one-third received long-term corticosteroid therapy. Tendon injury associated with fluoroquinolone use is significant, and risk factors such as renal disease or concurrent corticosteroid use must be considered when these agents are prescribed.

\*\* The “up to one-half of patents” mentioned in the quote above is 1/2 of the patients with reported tendon problems, not 1/2 of those who took the drug

The likelihood is low in healthy patients, probably less than 0.5% (also quoted from the same article); the risk is significantly higher for other groups, such as renal transplant patients:

> [@](#):
>
> The incidence of fluoroquinolone-induced tendon injury in an otherwise healthy population is not well established, but reports suggest that it is low, ranging from 0.14% to 0.4%

I would just point out that while a (possibly as high as) 1 in 200 chance of tendinopathy (half of those being ruptures) is not bad if you are being treated for anthrax, It’s not so great for just-in-case scenarios with minor benefit.

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