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All people get sick periodically, and many of them have to resort to taking antibiotics. There is a widespread belief in society that these drugs are incompatible with alcohol, but what to do if the treatment period coincides with the holidays? Where is the truth and where are the legends in our ideas about the interaction of antibiotics with alcoholic beverages?

Antibiotics and alcohol

Antibiotics are medications designed to fight bacteria. They penetrate pathogenic microorganisms or interfere with their metabolism, disrupting it completely or partially.

Doctors still have different views on the issue of the compatibility of antibiotics with alcohol and when you can drink after therapy. There are many doctors who strongly recommend that patients completely avoid alcoholic beverages during therapy in order to avoid. They explain this by saying that these drugs, together with ethanol, destroy the liver and negate the effectiveness of treatment.

To date, a lot of research has been carried out, the results of which allow us to confidently say: pharmachologic effect Most antibiotics do not worsen under the influence of alcohol, and the load on the liver does not increase.

However, alcohol itself causes intoxication and dehydration. If you take antibiotics with large doses of alcohol, the body will weaken, and in this case, the effectiveness of treatment will, of course, decrease.

There are also a number of antibiotics that react with ethanol in a disulfiram-like reaction. Their simultaneous use with alcohol is contraindicated, as this will cause intoxication, accompanied by nausea and vomiting, and convulsions. In very rare cases, death can occur.

Myths and reality

Historically, society has developed myths about complications after drinking alcohol during antibiotic treatment.

The main myths are as follows:

• Alcohol neutralizes the effect of antibiotics.
• Alcohol combined with antibiotics increases liver damage.
• Alcoholic drinks reduce the effectiveness of experimental therapy.

In fact, these theses are only partially true, which is confirmed by the results of numerous compatibility studies. In particular, the available data suggest that taking alcohol-containing drinks does not in any way affect the pharmacokinetics of most antibiotics.

At the turn of the 20th and 21st centuries, a lot of research was carried out on the combined effects of antibacterial drugs and alcohol. The experiments involved people and laboratory animals. The results of antibiotic therapy were the same in the experimental and control groups, but no significant deviations were found in the absorption, distribution and excretion of the active substances of the drugs from the body. Data from these studies showed that it is possible to drink alcohol while taking antibiotics.

Back in 1982, Finnish scientists conducted a series of experiments among volunteers, the results of which showed that antibiotics of the penicillin group do not react in any way with ethanol; therefore, they can be consumed with alcohol. In 1988, Spanish researchers tested amoxicillin for compatibility with alcohol: a group of subjects showed only minor changes in the rate of absorption of the substance and the retention time.

Besides, in different time scientists from different countries made similar conclusions about erythromycin, cefpirome, azithromycin and many other antibacterial drugs. It was also found that the pharmacokinetic parameters of some antibiotics, for example, the tetracycline group, are significantly reduced under the influence of alcohol. However, fewer drugs with this effect have been identified.

The common belief that alcohol and alcoholic beverages increase liver damage has also been refuted by scientists around the world. More precisely, alcohol can increase the hepatoxicity of antibacterial drugs, but only in very rare cases. This fact becomes rather an exception to the rule.

Scientists have also proven that ethanol has no effect on the antibiotics azithromycin, travofloxacin and ceftriaxone, used in the treatment of experimental pneumococcal infection among experimental rats. Interesting results were obtained during experiments with moxifloxacin: it turned out that rats that received small doses of alcohol while taking the drug were cured faster.
Why is it common to say that alcohol and antibiotics are incompatible:

Reasons for incompatibility

Despite the fact that the safety of simultaneous use of most antibiotics with alcohol has been proven, there are a number of them. These are the drugs active substances which enter into a disulfiram-like reaction with ethyl alcohol - primarily nitroimidazoles and cephalosporins.

The reason why you can’t take both antibiotics and alcohol at the same time is that the above mentioned drugs contain specific molecules that can change ethanol metabolism. As a result, there is a delay in the excretion of acetaldehyde, which accumulates in the body and leads to intoxication.

The process is accompanied by characteristic symptoms:

• intense headache;
• rapid heartbeat;
• nausea with vomiting;
• heat in the areas of the face, neck, chest;
• difficulty breathing;
• convulsions.

A disulfiram-like reaction is used in coding for alcoholism, but this method should only be used under the strict supervision of a specialist. Poisoning during treatment with nitroimidazoles and cephalosporins can be caused by even a small dose of alcohol. Alcohol abuse in this case can result in death.

Doctors allow small amounts of alcohol during treatment with penicillins, antifungals, and some antibiotics. wide range. A serving of fortified drink while taking these medications will not affect the effectiveness of therapy and will not cause negative consequences for good health.

When is it possible

Although it is okay to drink alcohol while taking most antibiotics, it is not okay to take them at the same time. The best way to take such medications is indicated in the instructions. For example, the effectiveness of erythromycin and tetracyclines is increased by drinking alkaline mineral water, and drinking sulfonamides, indomethacin and reserpine with milk.

If the antibiotic does not enter into a disulfiram-like reaction with ethanol, you can drink alcohol, but not earlier than 4 hours after the drug. This is the minimum time that antibiotics circulate in the blood, and accordingly is the answer to the question of how long you can drink after taking the drug. In any case, during the treatment period it is allowed to take only a small dose of alcohol, otherwise dehydration will begin in the body, and antibacterial drug it will simply be excreted in the urine.

conclusions

The myth about the incompatibility of antibiotics and alcohol appeared in the last century, and there are several hypotheses about the reasons for its occurrence. According to one of them, the authorship of the legend belongs to venereologists who wanted to warn their patients against drunkenness.

There is also an assumption that the myth was invented by European doctors. Penicillin was a scarce drug in the 1940s, and soldiers liked to drink beer, which has a diuretic effect and removes the drug from the body.

It has now been proven that alcohol in most cases does not affect the effectiveness of antibiotics and does not increase liver damage. If the active substances of the drug do not enter into a disulfiram-like reaction with ethanol, you can drink alcohol during treatment. However, you should follow 2 main rules: do not abuse alcohol and do not take antibiotics with it.

Antibiotic therapy helps get rid of infections of various etiologies. However, this method of treatment imposes certain restrictions on the usual way of life: many foods and even sunbathing are prohibited, since some antibacterial medications increase the body’s sensitivity to the effects of ultraviolet radiation.

Patients are not always able to strictly follow the doctor’s recommendations, especially when it comes to drinking alcoholic beverages. What happens if you drink alcohol while taking antibiotics, and how dangerous is ethyl alcohol when mixed like this?

Since the discovery of penicillin, the medical community has been interested in the interaction of alcohol and antibiotics. The first large-scale studies aimed at determining the compatibility of alcoholic beverages and antibiotic drugs date back to the end of the 20th century.

Laboratory tests conducted on animals and volunteers have demonstrated that alcohol has no significant effect on many antibiotics. The latter maintained their effectiveness indicators in both groups: both in the experimental and in the control groups. There were no significant deviations in the mechanisms of absorption, in the speed of onset of the pharmacological effect, its intensity and duration.

However, there are antibiotics that are absolutely incompatible with alcohol. For example, chloramphenicol and alcohol can cause seizures, even death.

What is the main danger of such a combination?

Basic side effects combinations of antibiotic therapy and alcohol intake are manifested by a disulfiram-like reaction, drug-induced hepatitis and toxic damage to the central nervous system.

1. By interfering with the metabolism of ethyl alcohol, antibiotics contribute to the accumulation of acetaldehyde in the body. Increasing intoxication is manifested by dyspeptic disorders and respiratory failure. The severity of the patient's condition with the development of a disulfiram-like reaction is enhanced by the fact that frequent vomiting leads to dehydration (increasing intoxication) and electrolyte imbalance (impaired heart rate, increased CNS depression). The most dangerous in terms of the frequency of such complications are cephalosporins and nitroimidazole ® derivatives.
2. Toxic liver damage occurs as a result of a violation of the metabolism of antibiotics, due to a conflict between the drug and ethyl alcohol for binding to the cytochrome P450 2C9 enzyme. This enzyme is responsible for removing alcohol metabolites and certain medications (erythromycin ® , ketoconazole ® , voriconazole ® , etc.) from the body. As a result of the conflict, only ethyl alcohol is excreted, and drug metabolites accumulate in the body, causing severe intoxication and liver damage.
3. Toxic depression of the central nervous system occurs due to the combination of the sedative effects of alcohol and some antibiotics. It most often develops in older people and debilitated patients.

Is it possible to drink wine with antibiotics? Or strong alcohol?

Western experts have calculated the amount of alcohol that can be taken during antibiotic therapy. The UK Department of Health advises men to drink a maximum of 40 ml of ethanol, and women - 30 ml. This amount of pure alcohol is contained in approximately 100 ml of vodka or cognac (forty percent strength), and 400 ml of wine (twelve percent strength).

Liver healthy person will not suffer from 200 ml of strong alcohol, but such a dose has a detrimental effect on brain activity and the central nervous system. The fact is that some antibiotics are able to cross the blood-brain barrier. Alcohol damages the dendrites of the cerebellum and destroys the connection between neurons, and this is also accompanied by antimicrobial drugs that affect the functioning of the brain, blood vessels and provoking vestibular disorders.

High concentrations of alcohol in combination with an antibiotic lead to inhibition of inhibition processes in the cerebral cortex, increased toxic effects on the nervous system, polyneuropathies, inflammatory diseases peripheral nerves, etc.

Strong alcoholic drinks neutralize the effect of the antibiotic and also enhance the inhibition of the enzymatic activity of flora gastrointestinal tract, which leads to dysbiosis. When taken repeatedly, vodka and cognac activate inflammatory processes, worsening the general well-being of the patient. Dehydration of the body occurs, delaying complete recovery and eradication of the pathogen.

Can I drink beer while taking antibiotics?

Beer is a low-alcohol drink, which is why the temptation to drink it during antibiotic therapy is so great. A small amount of beer really won’t cause serious harm to your health. The danger lies in the fact that a person rarely limits himself to a half-liter bottle and drinks much more. When drinking 600-700 ml of strong beer, about 40-50 ml of pure alcohol enters the body.

Ethyl alcohol, even in small quantities, is a poison that has a detrimental effect on the cells of the body. It burns the mucous membranes of the gastrointestinal tract, provokes spasmodic contractions of blood vessels and causes changes in blood pressure.

Antimicrobial drugs destroy not only opportunistic flora, but also indigenous ones. Such an imbalance causes dysbiosis. The altered composition of microorganisms inhabiting the intestines is one of the contraindications to drinking beer, which will only worsen the course of the disease.

Tandem from medicine of this pharmacological group and beer is dangerous because the alcoholic drink contains carbon dioxide ( carbon dioxide). This colorless gas accelerates absorption toxic substances, and the rate of chemical reactions increases.

Non-alcoholic beer and antibiotics: compatibility and consequences

Non-alcoholic beer actually contains between 0.2 and 1% pure ethyl alcohol. However, experts are wary of such a symbiosis, since patients compensate for a small percentage of alcohol content with a large amount of alcohol consumed.

Also, the low-alcohol drink is a diuretic, which increases the nephrotoxicity of the antimicrobial agent. Alcohol that has entered into chemical reaction with an active pharmaceutical substance, can cause the following complications:

• headache;
• dyspeptic disorders;
• weakness, lethargy and malaise.

Antibiotics and alcohol: compatibility and consequences

Now let's look at these two concepts separately.

Compatibility

Remember that there are antibiotics, in the treatment of which a strict taboo is imposed on alcoholic libations. Below is a table of compatibility between antibiotics and alcohol.

* n- incompatible;
* d-permissible after consultation with a doctor.

Treatment with Erythromycin ® , Metrogyl ® , Tinidazole ® , Flagyl ® , Moxalactam ® , Bactrim ® , Trimethoprim-sulfamethoxazole ® and cephalosporins requires complete abstinence from strong drinks.

Consequences

The incompatibility of alcohol and antibiotics is fraught with the development of a disulfiram-like reaction, which reduces the metabolism of ethanol. Acetaldehyde accumulates in the body, increasing the intoxication of the body. Vomiting, an unpleasant feeling of discomfort in the epigastrium, shortness of breath, increased blood pressure and tachycardia appear. Similar action has the drug disulfiram, used in the treatment of alcoholism.

When taking antibiotics and ethanol together, the metabolic processes. The fact is that ethyl alcohol and pharmacological agents decompose under the influence of the same enzymes. When drinking alcohol, the oxidative biotransformation of antibiotics slows down, and enzymes focus on detoxifying the body from alcohol.

Alcohol combined with antibiotics has a powerful sedative effect.

Suppression of the central nervous system and decreased concentration are dangerous for older people, for those who manage vehicle and is potentially engaged dangerous species activities that imply the presence of a high speed of psychomotor reactions.

It is worth highlighting the consequences of drinking beer during antibiotic therapy:

• allergic reactions (anaphylaxis, skin rashes, nettle fever, Jarisch-Herxheimer reaction, bronchial asthma allergic genesis);
• ulcerative lesions;
• cochlear neuritis;
• tinnitus;
• frequent bowel movements;
• enterocolitis;
• intracranial hypertension;
• decreased hemoglobin and platelet levels;
• dyspepsia;
• dysfunctions of the central nervous system, cardiovascular system;
• toxic kidney damage.

Why shouldn't you drink alcohol while taking antibiotics?

1. Inactivation or increased toxicity of the drug is observed.
2. Toxic metabolites distort the effect of antimicrobial drugs.
3. There is an increase in the half-life of ethanol.
4. The risk of allergic reactions increases.
5. The filtration and detoxification functions of the liver are impaired.
6. The neutralization of xenobiotics by the body slows down.

How soon can you drink alcohol after taking antibiotics?

After completing antibiotic therapy, it is better not to drink strong drinks without consulting your doctor. All the necessary information about how long after taking antibiotics you can drink alcohol is contained in the instructions for medical use drug. Please read the following points carefully:

• duration of treatment;
• compatibility of drugs with ethanol;
• section that indicates how much you should not drink after taking antibiotics.

On average, abstinence from alcoholic beverages lasts from 3 to 7 days.

The length of the period depends on the type pharmacological agent and on the speed of its excretion. If the annotation does not contain information about compatibility with ethyl alcohol, then stop drinking alcohol for at least 24 hours after finishing treatment. For example, when taking tinidazole, you should abstain for at least 72 hours.