Editing Antibiotic (section)

==Side effects==
[[File:Choosing Wisely antibiotics poster small English.pdf|thumb|right|Health advocacy messages such as this one encourage patients to talk with their doctor about safety in using antibiotics.]]
Antibiotics are screened for any negative effects before their approval for clinical use, and are usually considered safe and well tolerated. However, some antibiotics have been associated with a wide extent of adverse [[side effect]]s ranging from mild to very severe depending on the type of antibiotic used, the microbes targeted, and the individual patient.<ref name="pmid15993671"/><ref>{{cite journal | vauthors = Slama TG, Amin A, Brunton SA, File TM, Milkovich G, Rodvold KA, Sahm DF, Varon J, Weiland D | title = A clinician's guide to the appropriate and accurate use of antibiotics: the Council for Appropriate and Rational Antibiotic Therapy (CARAT) criteria | journal = The American Journal of Medicine | volume = 118 | issue = 7A | pages = 1S–6S | date = July 2005 | pmid = 15993671 | doi = 10.1016/j.amjmed.2005.05.007 | collaboration = Council for Appropriate Rational Antibiotic Therapy (CARAT) | doi-access = free | title-link = doi }}</ref> Side effects may reflect the pharmacological or toxicological properties of the antibiotic or may involve hypersensitivity or [[allergy|allergic]] reactions.<ref name=Antibioticandantiprotozal/> Adverse effects range from fever and nausea to major allergic reactions, including [[photodermatitis]] and [[anaphylaxis]].<ref>{{cite web |title=Antibiotics – Side effects |website=NHS Choices |publisher=National Health Service (NHS), UK |url=http://www.nhs.uk/Conditions/Antibiotics-penicillins/Pages/Side-effects.aspx |date=6 May 2014 |access-date=6 February 2016 |archive-date=7 February 2016 |archive-url=https://web.archive.org/web/20160207044627/http://www.nhs.uk/Conditions/Antibiotics-penicillins/Pages/Side-effects.aspx |url-status=live }}</ref>

Common side effects of oral antibiotics include [[diarrhea]], resulting from disruption of the species composition in the [[intestinal flora]], resulting, for example, in overgrowth of pathogenic bacteria, such as ''[[Clostridioides difficile (bacteria)|Clostridioides difficile]]''.<ref>{{cite web|title=Antibiotic-Associated Diarrhea – All you should know|access-date=28 December 2014|url=http://www.bestnaturalremedies.net/antibiotic-associated-diarrhea|archive-date=25 April 2015|archive-url=https://web.archive.org/web/20150425102547/http://www.bestnaturalremedies.net/antibiotic-associated-diarrhea|url-status=dead}}</ref> Taking [[probiotics]] during the course of antibiotic treatment can help prevent antibiotic-associated diarrhea.<ref>{{cite journal | vauthors = Rodgers B, Kirley K, Mounsey A | title = PURLs: prescribing an antibiotic? Pair it with probiotics | journal = The Journal of Family Practice | volume = 62 | issue = 3 | pages = 148–50 | date = March 2013 | pmid = 23520586 | pmc = 3601687 }}</ref> Antibacterials can also affect the [[vaginal flora]], and may lead to overgrowth of [[yeast]] species of the genus ''[[Candida (genus)|Candida]]'' in the vulvo-vaginal area.<ref name="Pirotta and Garland"/> Additional side effects can result from [[drug interaction|interaction]] with other drugs, such as the possibility of [[tendon]] damage from the administration of a [[quinolone antibiotic]] with a systemic [[corticosteroid]].<ref>{{cite journal | vauthors = Lewis T, Cook J | title = Fluoroquinolones and tendinopathy: a guide for athletes and sports clinicians and a systematic review of the literature | journal = Journal of Athletic Training | volume = 49 | issue = 3 | pages = 422–7 | date = 1 January 2014 | pmid = 24762232 | pmc = 4080593 | doi = 10.4085/1062-6050-49.2.09 }}</ref>

Some antibiotics may also damage the [[mitochondrion]], a bacteria-derived organelle found in eukaryotic, including human, cells.<ref>{{Cite journal |last1=Prezant |first1=Toni R. |last2=Agapian |first2=John V. |last3=Bohlman |first3=M. Charlotte |last4=Bu |first4=Xiangdong |last5=Öztas |first5=Sitki |last6=Qiu |first6=Wei-Qin |last7=Arnos |first7=Kathleen S. |last8=Cortopassi |first8=Gino A. |last9=Jaber |first9=Lutfi |last10=Rotter |first10=Jerome I. |last11=Shohat |first11=Mordechai |last12=Fischel-Ghodsian |first12=Nathan |date=July 1993 |title=Mitochondrial ribosomal RNA mutation associated with both antibiotic–induced and non–syndromic deafness |url=https://www.nature.com/articles/ng0793-289 |journal=Nature Genetics |language=en |volume=4 |issue=3 |pages=289–294 |doi=10.1038/ng0793-289 |pmid=7689389 |issn=1546-1718}}</ref> Mitochondrial damage cause [[oxidative stress]] in cells and has been suggested as a mechanism for side effects from [[fluoroquinolone]]s.<ref>{{cite journal | vauthors = Marchant J | title = When antibiotics turn toxic | journal = Nature | volume = 555 | issue = 7697 | pages = 431–433 | date = March 2018 | pmid = 29565407 | doi = 10.1038/d41586-018-03267-5 | doi-access = free | title-link = doi | bibcode = 2018Natur.555..431M }}</ref> They are also known to affect [[chloroplast]]s.<ref>{{cite journal | vauthors = Wang X, Ryu D, Houtkooper RH, Auwerx J | title = Antibiotic use and abuse: a threat to mitochondria and chloroplasts with impact on research, health, and environment | journal = BioEssays | volume = 37 | issue = 10 | pages = 1045–53 | date = October 2015 | pmid = 26347282 | pmc = 4698130 | doi = 10.1002/bies.201500071 }}</ref>