As all pharmaceuticals, antibiotics can have medicine-related side effects such as rashes, nausea and diarrhea. Some can cause severe side effects such as kidney toxicity or central nervous system symptoms.
Serious adverse effects are rare overall but of great importance in clinical practice. For severe antibiotic resistant infections, older antibiotics with more toxic side effects may be the only option left. Antibiotics can also cause allergic reactions. Skin rashes and itching are usually mild and treatment can continue. However, in rare cases severe allergic reactions occur, including anaphylactic shock, and may progress to life-threatening conditions that must be treated promptly.
Examples of side effects
- Gastrointestinal side effects (abdominal pain, nausea, vomiting or diarrhea) are typically reported in 1-10 % of treated patients for most antibiotics. Certain antibiotics are reported to cause diarrhea in 20-25% of the patients. Treatment will sometimes be discontinued due to gastrointestinal side effects.
- Colistin is a last resort drug for highly resistant infections caused by Gram-negative bacteria. Colistin treatment in some cases have toxic effects on the kidneys.
Emergency department visits for antibiotic side effects
In American study based on adverse drug events surveillance, antibiotics were implicated in around 14% of all emergency department visits for adverse events.
Oral sulfonamides, penicillins and quinolones were the most commonly implicated antibiotic classes.
Mild allergic reactions (for example rash) were the most commonly documented adverse event. Moderate-to-severe allergic reactions such as anaphylaxis occurred in about one fourth of cases involving oral quinolones (26.2%). Gastrointestinal disturbance like nausea, diarrhea and abdominal pain, was documented in around 25% of visits involving metronidazole, macrolides, and tetracyclines.
Selected Resources
| Resources | Description |
| Association of Adverse Events With Antibiotic Use in Hospitalized Patients | Journal article that describes adverse events related to antibiotic use. The authors conclude that adverse drug reactions are common during antibiotic therapy, and that many events can be avoided with better antibiotic use. |
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