It is impossible to imagine modern medicine without antibiotics, and they themselves have gone far ahead of penicillin, invented almost a hundred years ago. Today they are able to fight superbugs and treat uncomplicated appendicitis, and they are trying to get them from the most unexpected sources – whether it be soil, anthill, blood from a chest of drawers or milk from a duckbill. An endless search is associated with the fact that the longer humanity uses antibiotics, the higher the likelihood of bacteria resistance to them – that is, the risk that new drugs will be required. And considering that even the Neanderthals were treated with antibiotics without suspecting it, it becomes clear that the bacteria had enough time to adapt.

No less important than bacterial resistance is the problem – we know too little about antibiotics. More precisely, we already have enough knowledge about them, but for some reason we continue to believe in myths: many people are still convinced that antibiotics can cure the flu, although it is useless to treat viral infections with them. This is just one of the common misconceptions. We have collected ten more that will help to understand what antibiotics are and why they are more likely safe than dangerous, but they should not be abused anyway.

1. Antibiotics should be taken with probiotics

Antibiotics destroy bacteria, and probiotics restore intestinal microflora – it sounds logical. However, in fact, antibiotics in most cases do not cause either dysbiosis or thrush. Of course, a small risk persists, but usually the only thing a person faces a course of antibiotics is short-term diarrhea.

With regard to probiotics, if you do not take commercial studies into account, doctors are skeptical: further studies are needed to understand which strains of bacteria are most useful and in what doses. Mayo Clinic experts are sure that the best way to get your gut in order is to drink plenty of fluids and choose a softer drink compared to a regular diet, as well as reduce the amount of fiber.

2. Antibiotics should always be drunk.

All of us have heard more than once that the course of antibiotics must be completed – however, researchers are not sure that this is so necessary if you feel better. According to recent data, early termination of antibiotic therapy does not contribute to the development of resistance to them, but longer than necessary, taking it just increases this risk. In addition, for the convenience of the patient, they try to create new drugs so that they do not need to be taken for a long time – and there are even antibiotics for a single dose.

However, there are a number of diseases (the most obvious example is tuberculosis), in which refusal of the drug in the middle of the course can lead to serious consequences. Experts say that the ideal length of the course of treatment has not yet been determined – it varies among different people and depends on what antibiotics were used in humans in the past.

3. Always do a sensitivity test.

Such tests really help to avoid many problems and prescribe an antibiotic that will work just as fast as the doctor would like. But in many cases, the medical algorithm first involves prescribing a broad-spectrum drug that acts on different types of bacteria, including the most likely for this disease.

Only then, if necessary, is another antibiotic prescribed to solve a narrower problem. Moreover, research results show that antibiotics of the first type can be at least as effective.

4. Antibiotics – an absolute evil for children and pregnant women

Researchers believe that pregnant women should use antibiotics with caution. Which, however, does not mean that they are prohibited – it is only important to think about their appropriateness in each specific case. Antibiotics are not dangerous, but only if they are taken according to indications and in the correct mode.

Recently, the World Health Organization updated the list of essential medicines, dividing antibiotics into recommended, controlled and reserve ones – this is important for prescribing the “right” antibiotics in each individual case.

5. Injections are better than pills

A couple of decades ago, injectable rather than oral antibiotics were more often used in hospitals. This was entirely justified, since the doctors had in their arsenal imperfect preparations, and their choice was rather small. The bioavailability (that is, how much drug actually entered the bloodstream) was then higher for injectable forms (about 80%, and for tablets it was 40-60%).

Since then, much has changed in the world of antibiotics: they have become more perfect, “learned” to work faster, and tablets finally boasted 90–95% bioavailability – this made intramuscular injections a relic of the past, especially given their pain; with intravenous administration, the medicine will really work faster, but this is rarely needed. Antibiotics in tablets are easier to use and much safer. True, some drugs can not yet be enclosed in tablet form – they will simply be digested by enzymes in the stomach.

6. Antibiotics can be used for prevention

Antibiotic prophylaxis is used to reduce the risk of infections associated with open fractures and wounds, including after surgery, and in such cases it is justified. But often, antibiotic prophylaxis means the prevention of infections in everyday situations – for example, when a person goes on vacation to an unfamiliar country and wants everything to go smoothly.

This is primarily an intestinal disorder known as traveler’s diarrhea, which occurs when the diet or the climate zone changes. However, doctors around the world agree that such prevention is an excess. It is more correct and safer to be careful about the choice of water and food and, as an option, ask your doctor to recommend an antibiotic in case the problem does occur.

7. Resistance arises only due to the constant use of antibiotics

The widespread use of antibiotics has accelerated the pace at which bacteria become resistant to them. But to think that only regular and uncontrolled use of antibiotics can lead to resistance is wrong. Scientists have found that genes for antibiotic resistance can be to blame, which give bacteria the ability to destroy antibiotics of the carbapenem class – one of the main means against extremely dangerous superbacteria.

Not so long ago, it turned out that some bacteria in the struggle for territory destroy other microbes, “picking up” the remains of their DNA, which may contain antibiotic resistance genes, and this complicates the task. At the moment, a thorough study of plasmids — molecules that carry genetic information — and the development of tools that prevent resistance genes from attaching to these plasmids seem to be a promising solution to the problem.

8. Any antibiotic is better than nothing.

Are there universal antibiotics that will help in any case? The answer is unequivocal: no. There are drugs with a wide spectrum of action, but even they are always prescribed taking into account which type of bacteria is most likely in the patient. So the position “I’ll finish this antibiotic so as not to buy a doctor’s prescribed” does not work.

According to experts, about 50% of antibiotics worldwide are purchased without a prescription. And this is not good: in addition to general concern about the growing number of antibiotic-resistant bacteria, there is a risk of overshooting, if not with the type of medicine, then with its dosage or compatibility with other drugs that require constant use. In addition, the use of antibiotics to combat weak bacterial infections, such as pharyngitis or bronchitis, is most often not required, as our immune system is able to cope with this on its own.

9. Antibiotics in meat – a threat to health

To begin with, antibiotics are not used uncontrollably as growth stimulants or to treat infections in animals – and research on this topic is ongoing. And while none of them has allowed us to reasonably talk about the dangers of such use for people – it’s another matter that the amount of red meat in the diet is better limited for other reasons.

It should be borne in mind that even in organic, natural or biodynamic farming, animals are treated with antibiotics, if necessary. Although, in fairness, recently, WHO asked farmers not to do this without special need.

10. Antibiotics are not compatible with alcohol.

Most commonly prescribed antibiotics are compatible with alcohol. In any case, one or two glasses of wine is not a reason to interrupt the course or think that antibiotics have ceased to act and their intake should be started again. They say that combining alcohol with antibiotics was forbidden during the Second World War. Then the production of the drug was not mass and it was used repeatedly – patients collected urine, from which they then received new penicillin. Beer, which the soldiers allowed themselves, increased the volume of urine, and it became more difficult to process it.

There are exceptions: metronidazole, trimethoprim and some other antibiotics should not be mixed with alcohol to avoid unpleasant side effects. And do not abuse alcohol during a course of antibiotics – it additionally weakens the body, which does not contribute to the fight against infection.