Question
Are antibiotics poisons?
Answer
A poison is defined by Merriam-Webster as a substance that through its chemical action usually kills, injures, or impairs an organism. Medications, including antibiotics, undergo extensive clinical studies to identify the best dose, maximizing the drug’s performance or efficacy with an acceptable safety profile. When we use antibiotics, the goal is to “poison” the organism causing the disease, while minimizing the “poison” effects on the patient. Pharmacists often refer to this balancing act as “the dose is in the poison.”
Direct and indirect consequences can occur, even when antibiotics are used appropriately. Antibiotics directly can cause a wide array of side effects on the human body. Side effects possible with any antibiotic include intolerances and allergies. Intolerance is often seen as an upset stomach or diarrhea. An example of antibiotic intolerance is an upset stomach when someone takes amoxicillin. Allergies on the other hand can range from a mild rash to life-threatening anaphylaxis. It is important to distinguish intolerances from allergies, as an allergy, especially a severe one, can suggest similar antibiotics may cause a similar allergic reaction.
In addition to direct effects on a human, antibiotics can also damage the host’s microbiome, often referred to as collateral damage. Antibiotics do not just kill the one bad bacteria causing infection, they kill all of the bacteria within their antibacterial spectrum, which can include “good bacteria” in or on our bodies. When disrupting the microbiome, antibiotic associated diarrhea may occur. A particularly bad type of diarrhea caused C. difficile infection may also occur, which can be recurrent and life-threatening.
The risks of antibiotic use truly underscores the importance of using them with caution, only prescribing them when truly necessary and appropriate. It is the responsibility of clinicians and the care team to strike a balance between reaping the benefits of antibiotics while mitigating their risks as potential poisons.
TL;DR Are antibiotics poison?
Perhaps not in the traditional sense, but their use is not without direct and indirect consequences which may cause them to illicit effects of a poison.
READINGS/ RESOURCES
- Viruses or Bacteria What’s got you sick?
- You’ve Been Prescribed an Antibiotic in the Hospital for an Infection
- Antibiotics Aren’t Always the Answer
- Are Antibiotics Needed For My Child’s Runny Nose? Q & A Guide for Parents
- Kentucky Antimicrobial Stewardship Innovation Consortium: Every Dose Matters
ANSWERED BY
Hunter O. Rondeau, Pharm.D. & Timothy P. Gauthier, Pharm.D., BCPS, BCIDP – September 2023
Q&A DISCLAIMER
The ID PharmD Q&A pages attempt to answer common pharmacy questions by providing the perspective and opinion of a trained expert with knowledge relevant to the question. That noted, these answers are not provided as all-inclusive comprehensive responses. This is not provided for direct patient care purposes.
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