Antibiotics, as you know, are medications that have been formulated in many different ways for the treatment of various infections. Like all good things, however, there are pros and cons to the use of these medications. As useful as antibiotics can be, they have also been associated with causing numerous side effects, some of which can be life-threatening. Some of these side effects are allergic reactions, which may be mild or severe, while others can be serious enough to threaten lives. The most common side effect in this category is diarrhoea and the most important organism responsible for this is known as Clostridium difficile.
It is also a documented fact that antibiotics can interfere with other medications, which we may be taken, thereby negating the effects of those other medications or failing to appropriately perform the role for which they are being taken. The danger of some of these problems is that bacteria that used to be very responsive to certain antibiotics have become more and more resistant. This situation makes it eminently possible for more serious infections to occur and for such infections to become far more difficult to treat. This is broadly known as antibiotic resistance. It is no longer a distant problem, but it is a real issue that is present with us on a day-to-day basis.
When you take antibiotics, especially if you don’t need to take them, you’re putting yourself, your family and your community at risk of developing infections, which in turn cannot be easily treated with antibiotics. This is a problem that breeds drug resistance as well. So, you end up with a cycle of constantly worsening nature of the said types of infection. This has been the most important consequence of the inappropriate use of antibiotics that currently faces the healthcare community. Therefore, taking antibiotics when they are not needed will not help you, while at the same time, the side effects they cause can still cause harm. As a result, it is important that the use of antibiotics should be regulated by healthcare professionals who will give the due directions for their use and what to do when certain adverse effects occur.
Frequently, especially in our dear country, it is the case that a greater proportion of antibiotic use is often self-prescribed. The information leading to such behaviour is obtained from friends and peers who would tell stories of having used similar antibiotics to treat similar ailments. But diseases are not the same and the fact that symptom complexes are similar in different individuals does not automatically mean that the disease condition is also the same. It is important therefore for people to properly understand that the use of antibiotics can have unwanted consequences.
Many antibiotics can comfortably treat a wide range of infections caused by bacteria. In the same way, antibiotics can be used as an adjunct to antiviral treatment in the face of viral infections so that they can protect people from opportunistic bacterial infections. Some of the common viral infections for which a lot of healthcare experts prescribe antibiotics but for which they have no proven efficacy include conditions like the common cold; most cause ear infections, stomach flu, and herpes febrilis infection.
However, we need to emphasise today that the topic of this discussion remains the diseases that antibiotic usage can cause. As we mentioned in the very first paragraph, antibiotics can cause allergic reactions which may be mild, moderately severe or severe. It is the duty of the healthcare personnel taking care of such people or the caregivers responsible for them to recognise the onset of these problems and act promptly. While allergic problems related to antibiotic use can often be spotted almost as soon as they begin, it is not necessarily the same when antibiotics cause diarrhoea, which can become a lot more serious. The huge problem with that is that such problems, which are known as secondary infections, can ultimately lead to catastrophic results.
More often though, only about one in five people who take antibiotics will end up with antibiotics-associated diarrhoea. Out of this number, only a small figure will require treatment. And that is because such diarrhoea will typically clear up within a few days once the use of the medication has stopped. In other cases, where it fails to resolve, the attending physician may prescribe an anti-diarrheal medication, such as loperamide, to control the frequency of stools.
Typically, diarrhoea is described as when a person passes stools more than three times a day, even if not all the stools are watery. When antibiotics are fighting an infection, they can also kill the good bacteria within your intestinal tract. When that happens, diarrhoea is the result. It is therefore easy to see that any antibiotics can actually cause diarrhoea. And this is a relatively common side effect whether it is an antibiotic that is taken by mouth or one that is taken as an injection. Broad-spectrum antibiotics are by nature designed to kill the widest range of bacteria, and they are the ones most likely to cause this kind of side effect. The common associated factors that accompany diarrhoea caused by antibiotics are lower abdominal pain, colicky intestinal pain, nausea, low-grade fever and vomiting. They may also lead to the passage of mucoid diarrhoea and pain within the anus while passing stool.
One of the ways to prevent this kind of complication from occurring is to use probiotics after a course of antibiotic medication. Probiotics are friendly bacteria or yeast contained in foods that are rich in fiber and act to help the digestive system to return to its normal level of functioning. Some people have found that a certain probiotic found in some brands of yoghurt helps to reduce the incidence of antibiotics-induced diarrhoea in adults.
Probiotics occur naturally in some foods while they are added to others. They can also be taken as concentrated supplements and it is important to know that there are literally hundreds of these kinds of agents. Probiotic supplements are sold in drug stores and groceries and health food stores in liquid, powder, and capsule forms. They are usually kept in refrigerated segments of the stores where they can be kept safe from the effects of heat. However, before you begin to use any probiotic, it is important that you hold a relevant conversation with your doctor so that you can be entirely certain that it is safe to use it together with your other medications. Additional steps you can take to deal with the consequences of these symptoms are to take a lot of water so that you can stay hydrated and also achieve the aim of replacing any fluids that you have lost through diarrhoea. Perhaps, the most common probiotic agent in our environment is garri.
The diagnosis of antibiotics-associated diarrhoea is usually made when the history behind its origin suggests that a particular antibiotic has been used. When that is the case, your doctor will obtain a sample of your stool and send it to the diagnostic laboratory, where it will undergo routine testing for the presence of bacteria. Usually, when you develop a C. difficile infection, the first step would be to stop the use of that particular antibiotic. You may also then be asked to stop the use of antacids and proton pump inhibitors, so that resolution can take place quickly. The treatment of this condition depends on the severity of the symptoms, but it is usual in very severe cases to hospitalise the affected patient and treat with a combination of intravenous fluids and antibiotics. If what has been caused is an allergic reaction, the treatment offered also depends on the severity of the reaction.
On the whole, however, a prescription for the administration of an antihistamine is often sufficient to deal with the allergy. It is important for anybody who takes an antibiotic at the slightest hint of infection to know that there are consequences for that kind of attitude and that there are adverse health effects caused by using an antibiotic that may not be agreeable with a person’s system.
Questions and anawer
Dear doctor, please, I need your prescription for the severe pain I am experiencing in the upper part of my right arm joint close to my armpit. It is painful to extend it and I have found it very difficult to raise up my right arm. It started two days ago. Please, there is no cash to go to a hospital and even USSD transfer is no more going. So please, I need your help. Just prescribe something for me to take to a pharmacy and buy. 080344*****
It is a serious matter with regard to the cash flow problem. However, what you can do in the interim is to take the simple medications first to deal with this problem, which appears to have begun quite suddenly. Paracetamol and Ibuprofen taken together at the direction of the attending pharmacist should help curb the pain until the situation with money improves. Take the medicines after food and there should be some needed relief from the pain.
Dear doctor, my mother is 84 years old and was recently discharged from a hospital in Abuja where she was taking treatment for serious hypertension and diabetes. In the last five days, she has been complaining about some pain in her right foot, near the heel. Can she take Tylenol 650mg? 080242*****
If it’s Tylenol you have at home, please feel free to use it for her provided she takes some food before it is used. Now, she can use 650mg every 4-6 hours depending on the severity of the pain and up to 1000mg every 4-6 hours, but with 650mg tablets, it will be difficult for you to make it 1000mg; so, stay with the 650mg per dose.
Dear doctor, earlier today, I was chewing bubble gum when I accidentally swallowed it. I have been very anxious about it since then. Is there any health implication? 080378*****
Bubble gum is not harmful and since you have swallowed it, you should pass it out with your stool within a few days. It should not take longer than three days provided you are the kind of person who goes to the toilet every day.
Dear doctor, thank you very much for all the work you are doing to improve the health consciousness of ordinary Nigerians. God bless you. Amen. My question refers to the issue of libido. I am 48 years old and married with four children. I am no longer able to meet with my wife as often as I would like. Many times, I have the wish to do so, but my erection will just embarrass me. What can I do to get back to my normal self? 090317*****
Thank you very much for your prayers and kind words. It is a pleasure to know that this column makes a difference to many people. With regards to the question you asked, it is natural to experience some reduction in libido but oftentimes, it is temporary and should recover. Depending on how long your experience has been, it is always wiser to see a doctor and get a proper examination. That will make it clear if there are hidden health problems or even active ones. Frequently, once the problem is identified, treatment is always possible. So, start with a hospital visit where basic tests can be conducted.
Dear doctor, I am a 50-year-old man recently diagnosed with high cholesterol level and left ventricular hypertrophy. My doctor, who ordered the tests, told me that I don’t have high blood pressure. So, what l don’t understand is what is straining my heart to the extent that my heart has been affected. Please, help me with answers before I get a stroke from excessive worry. What do you think I should do? 080294*****
Well, your doctor is often the best placed to determine some things about your medical history. However, in this case, it is possible that you haven’t been afforded the privilege of doing all the relevant tests that can confirm whether the cause of your heart disease is innate to the heart or due to some other influences. To this end, it will be useful to have ECG and echocardiography as well as a full blood count, blood sugar series and serum chemistry. When all these results are compared with what you presently have, a certain pattern may emerge to help determine what has happened to your heart.
Dear doctor, please is it true that there is no cure for kidney disease? One of my friends has been doing dialysis for almost two years and now, he is doing it three times a week. Yet, his condition does not seem to be improving. Sir, is this the fate of everyone who has to undergo this treatment? We have been coming to Gbagada now since 2021 and many people who started the process, at about the same time as my friend, have passed on. Is there any hope at all? 080341*****
Although people on dialysis for as long as your friend will almost certainly have serious chronic ailments, it is not true that anyone on dialysis ultimately perishes. Chronic illnesses that would necessitate renal dialysis are high blood pressure and diabetes causing terminal kidney damage. It is when such damage is irreversible that people like that will have to depend on dialysis. However, there are other reasons why people would require dialysis, such as primary kidney disease, kidney damage as a result of accidents, severe injuries sustained elsewhere in the body and severe blood loss. As a result, the latter set of causes would respond expeditiously to dialysis and go on to live normal lives, whereas those who have survived a lifetime of illness will almost certainly have no option besides undergoing a kidney transplant.
Dear doctor, if somebody is sure based on experience that they have malaria, is it wrong to take anti-malaria treatment? Must such a person do a blood test first? I just want to know what is applicable, sir. 080371*****
Most people in this environment probably know how they feel when they have malaria. There is nothing wrong if you proceed to use an anti-malaria medication based on how you feel. It is such a pervasive problem and the consequences of delaying treatment may be so damaging that even pregnant women are encouraged to use such medications if they feel they have malaria. There is a caveat, though, and that is that if you fail to improve significantly after the use of such a medication, it will probably be taken as an unfair practice if you do not get a blood test done for confirmation at least.
