Antibiotics: Conflicting advice


I have received a lot of conflicting advice about antibiotics. Some doctors say they should be taken exactly at the right time (every eight hours, for example). Others say this is not important as long as you take the correct number of doses in a day (morning, afternoon and evening, for example). Some say they have to be taken before meals; others say after. Most say to avoid alcohol, but at least one doctor has told me that that doesn't matter either.

Dr Fred Kavalier answers your health question:

All antibiotics have a recommended dosing schedule usually between one and four doses in 24 hours. The ones that can be taken once a day are broken down by the body more slowly, so a single dose lingers in the bloodstream. Others are broken down more quickly, so you have to top up more regularly to maintain the levels of the antibiotic in the bloodstream.My usual advice is to take the correct number of doses in 24 hours, spread over the waking hours. So, three times a day means one in the morning, one in the afternoon, and one before bedtime. I do not think it is ever necessary to wake up in the middle of night to take a dose.Amazingly, the recommended dosing schedule for certain antibiotics is different in different countries. Augmentin (a type of penicillin) is usually taken twice a day in the US, but three times a day in the UK. Also, some drugs are absorbed better on an empty stomach, others with food. Ask the pharmacist, not your doctor they don't usually know about this.Only one commonly used antibiotic will make you feel sick if you drink alcohol: metronidazole (sometimes known as Flagyl). But if you are ill enough to be taking antibiotics, it's probably not sensible to be spending too much time in the pub.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.

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