Editing Antibiotic (section)

== Interactions ==

===Birth control pills===
There are few well-controlled studies on whether antibiotic use increases the risk of [[oral contraceptive pill|oral contraceptive]] failure.<ref name="OC effectiveness">{{cite journal | vauthors = Anderson KC, Schwartz MD, Lieu SO | title = Antibiotics and OC effectiveness | journal = JAAPA | volume = 26 | issue = 1 | pages = 11 | date = January 2013 | pmid = 23355994 | doi = 10.1097/01720610-201301000-00002 }}</ref> The majority of studies indicate antibiotics do not interfere with [[combined oral contraceptive pill|birth control pills]],<ref name="Weaver1999"/> such as clinical studies that suggest the failure rate of contraceptive pills caused by antibiotics is very low (about 1%).<ref name="pmid10384856"/> Situations that may increase the risk of oral contraceptive failure include [[compliance (medicine)|non-compliance]] (missing taking the pill), vomiting, or diarrhea. Gastrointestinal disorders or interpatient variability in oral contraceptive absorption affecting [[ethinylestradiol]] [[serum (blood)|serum levels]] in the blood.<ref name="OC effectiveness"/> Women with [[Irregular menstruation|menstrual irregularities]] may be at higher risk of failure and should be advised to use [[contraception|backup contraception]] during antibiotic treatment and for one week after its completion. If patient-specific risk factors for reduced oral contraceptive efficacy are suspected, backup contraception is recommended.<ref name="OC effectiveness"/>

In cases where antibiotics have been suggested to affect the efficiency of birth control pills, such as for the broad-spectrum antibiotic [[rifampicin]], these cases may be due to an increase in the activities of hepatic liver enzymes' causing increased breakdown of the pill's active ingredients.<ref name="Weaver1999"/> Effects on the [[gut flora|intestinal flora]], which might result in reduced absorption of [[estrogen]]s in the colon, have also been suggested, but such suggestions have been inconclusive and controversial.<ref name="pmid3155374"/><ref name="pmid2256523"/> Clinicians have recommended that extra contraceptive measures be applied during therapies using antibiotics that are suspected to interact with oral [[contraceptive]]s.<ref name="Weaver1999"/> More studies on the possible interactions between antibiotics and birth control pills (oral contraceptives) are required as well as careful assessment of patient-specific risk factors for potential oral contractive pill failure prior to dismissing the need for backup contraception.<ref name="OC effectiveness"/>

===Alcohol===
Interactions between alcohol and certain antibiotics may occur and may cause side effects and decreased effectiveness of antibiotic therapy.<ref name="bmj"/><ref name="antibiotics-and-alcohol"/> While moderate alcohol consumption is unlikely to interfere with many common antibiotics, there are specific types of antibiotics with which alcohol consumption may cause serious side effects.<ref name="NHS"/> Therefore, potential risks of side effects and effectiveness depend on the type of antibiotic administered.<ref>{{cite journal | vauthors = Moore AA, Whiteman EJ, Ward KT | title = Risks of combined alcohol/medication use in older adults | journal = The American Journal of Geriatric Pharmacotherapy | volume = 5 | issue = 1 | pages = 64–74 | date = March 2007 | pmid = 17608249 | pmc = 4063202 | doi = 10.1016/j.amjopharm.2007.03.006 }}</ref>

Antibiotics such as [[metronidazole]], [[tinidazole]], [[cephamandole]], [[latamoxef]], [[cefoperazone]], [[cefmenoxime]], and [[furazolidone]], cause a [[disulfiram]]-like chemical reaction with alcohol by inhibiting its breakdown by [[acetaldehyde dehydrogenase]], which may result in vomiting, nausea, and shortness of breath.<ref name="NHS"/> In addition, the efficacy of doxycycline and [[erythromycin]] succinate may be reduced by alcohol consumption.<ref>{{cite book | vauthors = Stockley IH |year= 2002 |title= Stockley's Drug Interactions |edition= 6th |location= London |publisher= Pharmaceutical Press}}{{page needed|date=December 2013}}</ref> Other effects of alcohol on antibiotic activity include altered activity of the liver enzymes that break down the antibiotic compound.<ref name="Antibiotics FAQ"/>