Dr Karl › Dr Karl's Great Moments In Science

Alcohol and Antibiotics

Antibiotics have been one of the greatest success stories of modern medicine - up there with the discovery of vaccination, and the discovery that you shouldn't mix your drinking water and your toilet water. Like all drugs, antibiotics can have their bad side effects, but their benefits are enormous. Even so, some people wrongly believe the opposite. And in fact, lots of people also wrongly believe that you should not drink any alcohol while taking any of the antibiotics.

The Chinese first used antibiotics about 2,500 years ago. Back then, they realised that the fungus that grew on soybean curd could cure boils. This ancient wisdom was also known to the healers of Egypt and Mesopotamia, even earlier. The fungus was making a chemical (streptomycin), one of the first antibiotics. If you ate this antibiotic, it killed the bacteria that caused the boils. In fact, this same fungus, even today, gives us the antibiotic, streptomycin, that is our main defence against the bacterium (Yersinia pestis) that causes the Bubonic Plague.

The first really powerful and widely used antibiotic, penicillin, was discovered by Alexander Fleming way back in 1928. Once again, it was made by a fungus. But the "Golden Age" of antibiotics really began only in 1941, when a group of scientists at Oxford University, in England, Howard Florey, Ernst Chain, and Edward Abraham succeeded in making small quantities of pure penicillin. They were so concerned that a Nazi air raid would destroy their building and all their research, that when they went home each night, they would rub some of the fungus inside the pockets of their trousers, so that they would have some left with which to start up again - if their lab was flattened. They then ramped up from small quantities to mass production, by using some of the technology used to brew beer. The first batches of penicillin became available in 1943, and were first used only by the military. Then later, as larger quantities were produced, it was made available to civilians, first only for life-and-death cases, and then for general use in the community.

Penicillin was truly a miracle drug when it was first introduced. It worked quickly and effectively against pneumonia, meningitis and hundreds of other deadly diseases. It was also especially effective against what were then called "Venereal Diseases" (VDs) - now called Sexually Transmitted Diseases (STDs).

The VD Clinics of the 1950s and 1960s gave the somber and serious advice that alcohol should absolutely not be used while taking penicillin. But there were no significant chemical interactions between penicillin and alcohol. The real reason that this advice was given was for moral reasons, not pharmacological reasons. The medicos of the day were worried that alcohol would reduce the inhibitions of the sufferers, and that, while under the influence, they might get a little "frisky" and pass on their infection to another person, before the penicillin had a chance to cure the sexually transmitted diseases.

That's how the mythconception that alcohol should never be taken with antibiotics arose.

Even so, it's well known that alcohol can interact quite nastily with a small number of modern drugs such as tinidazole (Fasigyn) and metronidazole (Flagyl), potentially causing nausea, vomiting, abdominal cramps, headaches, fast heart rate and flushing. And alcohol can reduce the absorption of other antibiotics such as the doxycyclines and tetracyclines. But these few interactions are well known to both medical doctors and pharmacists.

Mind you, alcohol can put an extra load on your liver and immune system, can impair your judgment, liberate aggressive tendencies, reduce your energy state - and can be associated with staying up late, behaving recklessly, and not getting all the rest that your body needs to heal itself. So half a glass of an alcoholic beverage of our choice would be fine with most antibiotics.

^ to top