Dr. Tariq Jagnarine
Family Medicine/ Endocrinology/Diabetes
When someone starts to feel pain from a urinary tract infection or strep throat, they may be prescribed a course of antibiotics to recover. Antibiotics may be needed for many types of bacterial infections, but what we eat while we’re on this medication can impact how well it works – and whether we’ll feel better.
WHY DOES IT MATTER WHAT WE EAT?
Certain foods can interact with an antibiotic by reducing how well it is absorbed by the body, or by even blocking the medication; while other foods can intensify side effects like gastrointestinal upset.
Antibiotics are a double-edged sword. Although these drugs can clear up an infection, they can also affect the natural balance of bacteria in our system. That can lead to the nausea, gas, and diarrhoea many people experience while taking antibiotics.
If people are not familiar with a new medication, it’s always a good idea to ask for some guidelines from a pharmacist who is experienced in navigating food-drug interactions.
FOODS CAN INTERFERE WITH ANTIBIOTICS
* Dairy and calcium-rich foods – Whether it’s cheese, milk, coffee creamer, yogurt, or butter, the calcium in dairy products could be a problem. Tofu, kale, and chia seeds are also high in calcium. When these foods are eaten with certain antibiotics, like tetracyclines or fluoroquinolones (Cipro), the medicine can bind to the calcium, which prevents it from being absorbed by the body. These foods should be spaced to be taken at least two hours after taking the antibiotic, and six hours before the next dose.
* Fortified foods – Fortified foods can contain a high amount of calcium, creating the same problem that foods naturally high in calcium have – possibly interfering with the antibiotics. Common fortified foods include breakfast cereal, orange juice, and non-dairy milk. Space these foods to be taken at least two hours after taking the antibiotic, and six hours before the next dose.
* High-acid foods – Citrus fruits and juices like orange and grapefruit, soda, chocolate, and tomato products have a high acid content, which could decrease how much medicine is absorbed into the system for certain antibiotics. Space these foods to be taken at least two hours after taking the antibiotic, and six hours before the next dose.
* Caffeine – Some antibiotics can increase the effects of caffeine, and not in a good way. Antibiotics can keep the body from metabolising the caffeine, so it stays in the system longer. A cup of joe in the morning could lead to an increase in the diuretic effects of caffeine, jitters throughout the day, and a sleepless night. Stick to noncaffeinated beverages while taking antibiotics, and take plenty of water to stay hydrated.
* Alcohol – Put cocktails or a glass of wine with dinner on hold. It’s best to completely abstain from alcohol until 48 hours after completing the course of antibiotics, if taking metronidazole. Be on the lookout for alcohol or propylene glycol in mouthwash, cough medicine, or cold and flu products, and avoid these as well.
Consuming alcohol while taking certain antibiotics can cause severe nausea and vomiting, headache, and other side effects.
* Multi-vitamins and antacids – These products can contain minerals: primarily magnesium, calcium, aluminum, iron, or zinc, that bind to the antibiotic and keep it from working. People can take multivitamins and antacids, as long as they space them to be taken at least two hours after they take the antibiotic, and six hours before the next dose.
WHAT TO EAT INSTEAD
* Soup – Enjoy broth-based soups that don’t rely on cream, cheese or tomatoes for flavour; like chicken noodles, ramen, miso, or lentil. These soups often have beneficial prebiotic foods, like garlic, onion, vegetables, and beans, that help healthy bacteria regrow.
* Bland foods – In general, foods for when people are sick are also appropriate when they are taking antibiotics. Plain or lightly salted crackers, peanut butter, and non-citrus fruit are good choices. The BRAT diet (bananas, rice, applesauce, toast) can help with diarrhoea from antibiotics.
* Water – Staying hydrated is important, especially when sick. It helps the body fight the infection, the medication to work properly, and combat some of the gastrointestinal side effects of antibiotics.
* Fermented foods – Sauerkraut, kimchi, miso, fermented vegetables, and kombucha contain beneficial probiotics that can support the gut, and can help offset some of the unpleasant side effects of antibiotics. Yogurt and kefir can also be helpful. Ensure dairy products are appropriately spaced from the antibiotic.
* Probiotic supplements – Taking probiotics while on antibiotics can help provide beneficial bacteria to the system, and may also help with diarrhoea.
TAKE ANTIBIOTICS PROPERLY
* Always follow the instructions on the medication label. Always finish the regimen, even if starting to feel better. Don’t save antibiotics for another time.
* Some antibiotics should not be broken, crushed, or chewed; so, check the label.
* Don’t miss doses; take them as soon as possible, unless it’s almost time for the next dose, about three to four hours. Doses are timed to keep a consistent amount of medicine in the body. Taking the doses too close together, or taking a double dose can increase the side effects, and doesn’t have any benefit.
* If the label says to take it with food, take the medicine with a meal or a little snack, like crackers and fruit. Food helps the body to absorb certain medications, and can reduce side effects.
* If the label says to take on an empty stomach, time the meals to be either one hour after taking the medicine or two hours before the next dose. Some medicines work better if there is no other food in the stomach.
* After finished with antibiotics, help healthy bacteria grow
According to a study of intestinal bacteria published in the journal Clinical Infectious Diseases, gut microbiota mostly repopulates within two to four weeks of finishing a course of antibiotics. However, it can take up to a year or longer for the gut microbiome to fully recover.
Other bacterial colonies on the body can also be affected by antibiotics. For example, women can occasionally develop a yeast infection after a round of broad-spectrum antibiotics, because the antibiotics clear out beneficial bacteria in the vagina.
It’s also helpful to limit sugar and processed foods for several weeks, as these can suppress healthy bacterial growth.
Antibiotics are sometimes necessary, but the medical community is still learning the full long-term effects on the body. Take the medicine as prescribed, and talk to the pharmacist if you have any questions about the right way to take antibiotics.