Antibiotiques

Qu'est-ce qu'un antibiotique ?

Antibiotics are a group of medicines that are used to treat bacterial infections. Antibiotics are sometimes called antibacterials or antimicrobials.

Antibiotics can be taken by mouth as:

• Liquide.

• Tablettes.

• Gélules.

Ils peuvent également être administrés par l'intermédiaire d'un ordinateur :

• Crème ou pommade.

• Injection.

Antibiotiques par injection

People who need to have an antibiotic by injection will have this started in hospital because they have a severe infection. Sometimes the hospital team will continue overseeing antibiotics by injection after leaving hospital, particularly if the course of antibiotics needs to be continued for several weeks.

Comment les antibiotiques agissent-ils ?

Certains antibiotiques agissent en tuant les bactéries (ou les parasites). Cela se fait souvent en interférant avec la structure de la paroi cellulaire de la bactérie ou du parasite. Certains agissent en empêchant la bactérie ou le parasite de se multiplier.

Les antibiotiques agissent-ils sur les virus ?

No, antibiotics do not kill viruses. This is for 2 reasons:

• Antibiotics are designed to target bacteria - either by killing them or stopping them from growing.

• Viruses are completely different from bacteria. They don’t have the structures or processes that antibiotics attack.

Types d'antibiotiques

Antibiotics are grouped together based on how they work. Each type of antibiotic only works against certain types of bacteria or parasites. This is why different antibiotics are used to treat different types of infection.

The main types of antibiotics are:

Outre les principaux types d'antibiotiques susmentionnés, il existe un certain nombre d'autres antibiotiques que les médecins spécialistes peuvent prescrire pour des infections plus rares telles que la tuberculose (TB).

Le reste de cette brochure ne traite que des antibiotiques qui peuvent être prescrits en médecine générale.

What do antibiotics treat?

Antibiotics are normally only used to treat bacterial infections that are unlikely to clear up on their own. These include:

• Urine infections.

• Pneumonie.

• Acné.

• Tonsillitis (sometimes known as Strep throat).

• Whooping cough.

• L'impétigo.

• Cellulite.

• Some ear infections (especially in younger children)

• Sexually transmitted infections such as chlamydia, gonorrhoea (with specific antibiotics) and syphilis.

Antibiotics are also used to treat more serious bacterial infections such as meningitis or pneumonia.

In the past antibiotics were also used to treat the following, but as our understanding has improved the treatment has changed:

• Most mild sinus infections (often viral or self-resolving).

• Most bronchitis cases (usually viral).

• Some ear infections (doctors may use “watchful waiting”).

• Traveller’s diarrhoea (often viral or toxin-based).

• Certain tummy bugs that improve without antibiotics.

How long do antibiotics take to work?

Antibiotics usually start working within 24-48 hours, but how quickly you feel better depends on the infection and the medicine. What happens usually is:

• First 24 hours: The antibiotic begins stopping bacteria from growing.

• 24-48 hours: Symptoms often start to improve (less pain, fever, or swelling).

• Several days: Most people feel much better, but bacteria may still be present.

• A few weeks: Coughs and colds will have gone completely.

The improvement time can vary due to:

• The type of infection you have, such as UTI, pneumonia, skin infection, etc.).

• The severity of the infection.

• Which antibiotic is used.

• Your immune system.

Quel antibiotique est généralement prescrit ?

Which antibiotic is prescribed mainly depends on where the infection is and which bacteria is likely to be causing the infection. This is because each antibiotic is effective only against certain bacteria and parasites.

D'autres facteurs influencent le choix d'un antibiotique. Il s'agit notamment de

• La gravité de l'infection.

• L'état de fonctionnement des reins et du foie.

• The dosing schedule (that is, how often you take the medication).

• Autres médicaments pris.

• Effets secondaires fréquents.

• Antécédents d'allergie à un certain type d'antibiotique.

• La grossesse ou l'allaitement.

• Modèle d'infection dans la communauté locale.

• Modèle de résistance aux antibiotiques des bactéries de la communauté locale.

Un certain nombre d'antibiotiques peuvent être pris sans danger pendant la grossesse ou l'allaitement.

Side effects of antibiotics

Common side effects of antibiotics are:

• Soft poo.

• Diarrhée.

• Sensation de malaise(nausée).

• Être malade (vomissements).

Antibiotic allergic reaction

Some people can have an allergic reaction to an antibiotic, most cases are often mild and can be treated by taking antihistamines.

In rare cases, some people can experience a severe allergic reaction, called anaphylaxis, which can be fatal.

Other side effects

Les autres effets secondaires importants sont les suivants :

• Severe watery diarrhoea and tummy (abdominal) cramps: signs of Clostridium difficile infection - a serious bacterial infection of the gut .

• Taches blanches sur la langue : signes de muguet buccal.

Les antibiotiques vous fatiguent-ils ?

Antibiotics don’t usually cause tiredness, but some people feel tired due to the infection itself or from side effects such as stomach upset. If tiredness is severe or persistent, contact a doctor.

Les antibiotiques peuvent-ils provoquer des gonflements ?

Some people can develop swelling as an allergic reaction to antibiotics. Mild cases affect the face or lips, but sudden or severe swelling needs urgent medical help.

Comment prendre des antibiotiques ?

It is important to take antibiotics in the correct way.

• Failing to do this may reduce how well they work. For example, some antibiotics need to be taken with food and others should be taken on an empty stomach.

• Taking antibiotics incorrectly will affect how much of them get into the body (their absorption) and therefore they may not work as well.

• It is important always to follow the instructions given by the doctor or pharmacist, and on the leaflet that comes with the antibiotic prescribed.

• It is also important always to take the entire course of antibiotics as prescribed. Even though it is common to feel better before the medicine is entirely finished, it is necessary to follow through and take the entire course.

• This is important for healing as, if an antibiotic is stopped in mid-course, germs (bacteria) may be partially treated and not completely killed. Bacteria may then become resistant to that antibiotic.

Antibiotic resistance

Antibiotic resistance is when bacteria change in ways that make antibiotics stop working against them.

In simple terms: the bacteria survive the medicine that used to kill them.

How does antibiotic use lead to resistance?

Antibiotic use can lead to resistance when bacteria adapt in ways - through mutation - that help them survive the medicine. While antibiotics kill most bacteria, a few with natural mutations may survive and multiply, becoming the dominant strain.

Overuse or unnecessary use gives bacteria more chances to adapt, while incorrect use - such as not finishing a course or taking the wrong antibiotic - also allows surviving bacteria to become resistant. Over time, this makes infections harder to treat because the antibiotics no longer work against these resistant bacteria.

Antibiotic resistance is far more common in countries where they are available over the counter without prescription.

Interactions

Certains antibiotiques peuvent interagir avec d'autres médicaments. Cela peut entraîner des réactions ou réduire l'efficacité de l'un ou l'autre des traitements.

Pilule contraceptive orale

Most antibiotics do not interfere with the effectiveness of the pill. The pill should be continued as normal.

The exceptions are rifampicin and rifabutin which are antibiotics used for tuberculosis or leprosy. They are known to affect the effectiveness of the pill.

Anticoagulants (such as warfarin)

• Certain antibiotics can increase bleeding risk.

• Doctors often monitor blood levels closely.

Pain relievers and anti-inflammatory drugs

• NSAIDs (like ibuprofen) can increase side effects with some antibiotics.

• Usually safe when used correctly, but should be taken as advised.

Heart and blood pressure medicines

• Some antibiotics can affect heart rhythm or drug levels.

• Examples include interactions with medicines for irregular heartbeat.

Seizure (epilepsy) medications

• Some antibiotics can change how seizure medicines work.

• Dose adjustments may be needed.

Antacids and supplements

These can block absorption of some antibiotics if taken together:

• Calcium.

• Le fer.

• Magnésium.

• Zinc.

• Antacids (like those for heartburn).

The problem is usually solved by spacing doses a few hours apart.

Alcool

• Alcohol can increase side effects (nausea, dizziness).

• A few antibiotics (like metronidazole) can cause a strong reaction with alcohol.

• Best advice: avoid alcohol while on antibiotics.

Compléments à base de plantes

• St. John’s wort can reduce effectiveness of some antibiotics.

• Always tell a healthcare provider about supplements.

Comment obtenir des antibiotiques

In the UK antibiotics are generally only available from a pharmacy, with a doctor's prescription. In some other parts of the world they are freely available over the counter.

However, to reduce the problem of resistance due to inappropriate use of antibiotics, it is best to always obtain medical advice before buying antibiotics.

Un pharmacien peut-il prescrire des antibiotiques ?

Some antibiotics can be prescribed by your pharmacist, for example to treat a urinary tract infection in certain age groups.

Pendant combien de temps prenez-vous des antibiotiques ?

La durée du traitement est très variable. Elle dépend du type d'infection, de sa gravité et de la rapidité avec laquelle les symptômes disparaissent après le début du traitement. Le traitement peut être

• Pendant trois jours (infection de l'eau - infection des voies urinaires (IVU)).

• Pendant une ou deux semaines (pneumonie).

• Pendant quelques mois (infections osseuses).

• Pendant plusieurs mois (acné).

Qui ne peut pas prendre d'antibiotiques ?

Most people can take antibiotics, but some people cannot take certain antibiotics or need special caution. It depends on the person and the type of antibiotic.

People with antibiotic allergies

• Some people are allergic to antibiotics like:

  • Penicillin.

  • Amoxicillin.

  • Céphalosporines.

• Reactions can range from rashes to serious allergic reactions.

• These people must avoid those antibiotics and use alternatives.

Pregnant women (some antibiotics)

• Some antibiotics are not safe during pregnancy because they can affect the baby.

• Doctors choose pregnancy-safe options when needed.

Babies and young children (some antibiotics)

• Certain antibiotics can affect:

  • Teeth colour.

  • Bone growth.

• Doctors prescribe age-appropriate antibiotics.

People with certain medical conditions

People with the following conditions may not be able to take some antibiotics or need dose adjustments:

• Maladie rénale.

• Maladie du foie.

• Myasthénie grave.

• Seizure disorders.

People taking specific medications

• Some antibiotics interact with:

  • Anticoagulants.

  • Heart rhythm medications.

  • Epilepsy (seizure) medications.

• These people may need different antibiotics or monitoring.

Questions fréquemment posées

Combien de temps les antibiotiques restent-ils dans le système ?

La plupart des antibiotiques quittent l'organisme par l'urine ou le caca dans les 24 heures, mais leurs effets sur les bactéries intestinales peuvent durer des semaines, voire des mois.

Peut-on se sentir mieux après une seule dose d'antibiotiques ?

Les antibiotiques agissent rarement après une seule dose. Un soulagement rapide peut survenir en cas d'infection urinaire ou cutanée, mais dans la plupart des cas, le fait de se sentir mieux aussi rapidement signifie que les antibiotiques n'étaient pas nécessaires.

Peut-on prendre du paracétamol avec des antibiotiques ?

La prise de paracétamol avec la plupart des antibiotiques courants est généralement sans danger, car il peut aider à réduire la douleur ou la fièvre pendant que l'antibiotique traite l'infection. Cependant, il convient de toujours respecter les doses recommandées et de vérifier auprès d'un médecin ou d'un pharmacien.

Peut-on prendre des antibiotiques pendant la grossesse ?

Some antibiotics, like penicillin and cephalosporins, are usually safe to take during pregnancy. Others, such as tetracyclines or ciprofloxacin, aren’t recommended.

If you’re pregnant and need antibiotics, it’s always best to check with your doctor or midwife first.

Pouvez-vous prendre des antibiotiques et boire de l'alcool ?

It’s best to avoid alcohol whilst taking antibiotics. Some antibiotics, such as metronidazole, can cause severe nausea and vomiting if mixed with alcohol. Others, like trimethoprim or erythromycin, may also be affected.

Most antibiotics don’t directly interact with alcohol, but drinking whilst you’re unwell can slow recovery and make side effects worse.