What to know about side effects and allergic reactions from antibiotics

People often come into the emergency department with a long list of
antibiotics they say they’re allergic to. The problem with this is there
may not be many options left for the doctor to prescribe once so many
antibiotics are ruled out.

While there are legitimate life-threatening allergies to antibiotics,
people may also be mistaking something else for an allergy. There isn’t an
allergy test for every antibiotic. Yes, allergies to certain antibiotics
may run in the family, but just because a parent is allergic to an
antibiotic, it does not necessarily mean the child will be. Parents will
say, “I had a bad reaction or I’m allergic to penicillin, so I don’t want
my child to have the antibiotic.” That has just eliminated one of the most
common antibiotics out there.

And remember, antibiotics can only be used for

some types of bacterial infections
. They are not effective against viral infections like the common cold, the
flu, or COVID-19.

Common Side Effects of Antibiotics

A lot of times what people think is an allergy, may just be a common side
effect. It’s important to know

the difference between an allergy and a side effect
. Side effects may occur naturally, or they can happen when an antibiotic
is not taken properly. They are normal occurrences, and not the sign of an
allergy. These are some of the most common side effects of antibiotics:

• Rash (could be from sun sensitivity while taking an antibiotic)
• Diarrhea
• Bloody diarrhea (adults), thrush (baby) — These can be signs that you or a
child have been taking an antibiotic for too long.
• Stomach pain
• Nausea/upset stomach
• Vomiting
• Fatigue
• Muscle pain

If you experience any of these side effects, contact your doctor to discuss
next steps. Your doctor may either adjust your dosing or switch you to
another antibiotic.

Read the Label

There are many reasons why a person may experience a side effect after
taking an antibiotic. One of the main reasons is that the person is not
taking it exactly as directed. That is why it’s important to read the label
and follow the directions! For example:

• Take as directed. If the label says to take the antibiotic on an empty stomach, with water,
or with food, then do that.

• Be mindful of the time.
If you are supposed to take the antibiotic every 12 hours, follow that
timeline. If you go outside the prescription parameters, you may experience
side effects.

• Store properly.
Some antibiotics need to be refrigerated.

• Complete the entire antibiotic course.
Make sure you take the antibiotic for the prescribed length of time. If you
were directed to take an antibiotic for a set number of days, and have some
left over after that timeframe, properly dispose of it. Do not save the
antibiotic for future use. Not all bacteria are treated with the same
antibiotic, and

taking expired medication can be harmful

• Watch the dosing.
If you miss a dose, wait for the next dose. Do not double up. Depending on
what antibiotic it is, talk to your doctor or your pharmacist about it. If
you have any left over, throw it out.

• Never share an antibiotic.
This is especially important for children (including siblings in the same
family, for example). Doctors base the dosage on the patient’s weight. And

shouldn’t share antibiotics
. If another family member starts showing symptoms, they should contact
their primary care doctor or urgent care (if their doctor is unavailable)
to ensure that they get the right antibiotic at the right dose for the
specific infection they have. Doctors are the experts in matching the
illness with the best treatment.

Other Ways to Reduce Side Effects

One way to

reduce the chance of side effects is by taking probiotics

such as yogurt, kefir, kimchi, or sauerkraut. Since antibiotics can kill
healthy bacteria along with disease-causing bacteria, you need to replenish
the good bacteria in your gut.

Another way to reduce the chance of side effects is to avoid any drug
interactions by

letting your doctor know what medications you are on

before taking an antibiotic. This includes things like over-the-counter
drugs that can interact with certain antibiotics. Oftentimes, people forget
to mention over-the-counter drugs and vitamins.

For example, there are some common cardiac medications that come from
natural sources. If you are on other herbal or natural drugs, your doctor
needs to know. Mixing medications from natural sources can cause unintended

Additional Things to Keep in Mind

• Antibiotics don’t treat COVID-19.
COVID-19 is a virus, and antibiotics only treat bacterial illnesses; they
cannot treat viruses. Antibiotics may be given to someone who has COVID-19
in order to treat a second respiratory infection, like pneumonia. It won’t
cure them of COVID-19, however.

• Try to administer antibiotics to children yourself.
The vast majority of antibiotics are given on a once- or twice-a-day
regimen. It’s best to

give the antibiotic to your child

yourself, rather than having someone at your child’s school or daycare give
it to them. Most pediatricians try to keep in mind where the children are
during the day and what they are doing before prescribing.

• Antibiotics travel through breast milk.
If you are breastfeeding, consult your doctor before taking any
antibiotics. Some antibiotics are not recommended when breastfeeding as
they could stain your baby’s teeth or cause diarrhea or other concerns.

This article was originally published on

IBX Insights

About Dr. Lynn Collins

I am a Pediatric Medical Director at Independence Blue Cross. In my current
role, I am responsible for utilization review, policy review, and
addressing any concerns regarding Pediatrics. I received my medical degree
from the University of Florida College of Medicine, and I am board
certified in Pediatrics.

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