published Friday, January 3rd, 2014

Follow the directions: Use caution when mixing antibiotics with other medications

Antibiotic Do's and Don'ts

• Do get regular vaccinations against drug-resistant bacteria.

• Do implement good hygiene methods by washing hands before eating to prevent ingesting drug-resistant bacteria.

• Do cook meat and poultry thoroughly to kill bacteria.

• Do seek medical attention if you have an allergic reaction to antibiotics.

• Do follow the instructions about dose and duration.

• Don't demand antibiotics when your doctor says you don't need them.

• Don't take antibiotics for viral infections.

• Don't skip doses or take someone else's antibiotics.

Source: Centers for Disease Control and Prevention

We've all done it or been tempted to.

You feel a tickle in your throat or notice a small rattle in your chest. So you head to the medicine cabinet to see if you have a few antibiotic pills left over from that strep throat you had a year ago, or maybe a dose or two of something the doctor gave you for that bladder infection.

Meds are meds, right?

"They are not the same at all," says Devony Webster, a physician's assistant in Dr. Bill Moore Smith's office on Lookout Mountain.

Taking something designed to fight a kidney infection will not necessarily work on your sinus infection, she says. While the proper antibiotic should knock out that pneumonia or strep throat, it does nothing to cure your cold. In fact, taking it for the cold means it is killing the wrong bacteria and putting you at risk for other illnesses.

"And, when you come in and we run tests, the tests are impaired, so we get altered results," she says. "It may not look like it, but there is a lot going on in my head when considering the best way to fix what is wrong with you. There is a lot to consider."

In an article at Alternet.org, Steve Solomon, director of the Center's for Disease Control's Office of Antimicrobial Resistance, described the issue as "the antibiotic paradox: the more you use antibiotics, the less effective they become."

According to a recent CDC report, at least 2 million people become infected with bacteria each year that is resistant to antibiotics, and least 23,000 people die as a result of those infections.

On top of that, 20 percent of all visits to a pediatric healthcare provider in the U.S. resulted in a prescription for antibiotics, Stephen Aronoff, a doctor at Temple University Hospital in Philadelphia, wrote on Philly.com. Of those 50 million prescriptions, he says, 10 million were prescribed for viral respiratory tract infections such as colds, runny noses, sore throats and most sinus infections, which cannot be treated by antibiotics.

Adding to the antibiotic anxiety, 70 percent of Americans take at least one prescription drug; half take at least two drugs prescribed by a doctor and 20 percent take as many as five, says a study by the Mayo Clinic released in June. And a 2011 study by the American College of Preventive Medicine found that 35 percent of Americans regularly take over-the-counter drugs to fight everything from headaches to colds to heartburn.

These drugs can -- and often do -- counteract each other. Just because you can walk into a drug store and legally buy something to fight your congested chest doesn't mean the medicine is safe for you, or that you don't need to follow the directions regarding when, where and how to take it. When you add in things like your age, previous health issues, current health and diet, getting the medicine and dosage correct can be tricky.

"Your basic chemistry knowledge does come in handy," Holly Lee, a clinical pharmacist with Erlanger Health System, says with a laugh.

It can get even more complicated if you are in poor health from some other issue, or if you are taking some other medication, she says. Perhaps the most important factor, she adds, is how often you talk to your doctor or your pharmacist about the proper way to take your meds, or if you take multiple medications, how they might interact.

"I can't stress enough how important your relationship with your physician or pharmacist is," says Lee.

Also, how often do you read -- and follow exactly -- the directions on the medications you take? "You need to fully read the directions. If it says to take it on an empty stomach, it means to take it on an empty stomach," Lee says.

And, she says, just because you feel better the next day doesn't mean you should stop taking the rest of the prescribed dosage.

"Take the whole bottle for as long as they tell you to take it," Lee says. "You may feel better, but you are not really over the infection, and [stopping] helps contribute to the lack of resistance later on."

The best advice when taking any medication, but especially if you take more than one, suffer from poor health in general or have been taking a medication for a lengthy period of time, is to speak honestly with your physician or pharmacist. If you have more than one doctor, it is especially important to use one pharmacist who can monitor and perhaps catch any conflicting prescriptions from different doctors.

"It is important, especially if you are taking something new, to talk to your pharmacist to make sure you understand how to take it and when to take it and what to take it with," Lee says. "He can also tell you of any major side effects to watch for.

"He can also review what you are taking and help you avoid any bad interactions."

Contact Barry Courter at bcourter@timesfreepress.com or 423-757-6354.

about Barry Courter...

Barry Courter is staff reporter and columnist for the Times Free Press. He started his journalism career at the Chattanooga News-Free Press in 1987. He covers primarily entertainment and events for ChattanoogaNow, as well as feature stories for the Life section. Born in Lafayette, Ind., Barry has lived in Chattanooga since 1968. He graduated from Notre Dame High School and the University of Tennessee at Chattanooga with a degree in broadcast journalism. He previously was ...

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