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Here our antibiotics experts aim to answer your questions regarding COVID-19, antibiotics and antibiotic resistant infections. If you have a question you'd like answered, you can use the form to ask our patient support team and we will answer it within 48 hours depending on the question's complexity.
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Antibiotic Resistance
Gallstones can cause blocking of the bile duct which can cause the gall bladder to become infected and inflamed. Symptoms of gall bladder infection (cholangitis) include:
- pain in your upper abdomen that travels towards your shoulder blade
- a high temperature
- jaundice
- chills
- confusion
- itchy skin
- generally feeling unwell
Your doctor will start you on a course of antibiotics to help get rid of the inflammation and infection. Once this has settled, they can perform surgery for removal of any stones causing the blockage. Therefore, it is important to take the antibiotic correctly at the given time and to complete the prescribed course.
Levofloxacin belongs to a group of antibiotics called fluoroquinolones and tendonitis is one of the common side effects of this group of antibiotics. The Medicines and Healthcare products Regulatory Agency (MHRA) advise that ‘treatment should be discontinued at the first signs of a serious adverse reaction, including tendon pain or inflammation’. Therefore, you should stop taking the antibiotics and see a doctor if you experience tendonitis. You will receive an alternative antibiotic treatment.
Further information can be found here.
A few people do experience tendonitis during and after they have taken Levaquin. Tendonitis is a known side effect of Levaquin. In these situations, if the symptoms don’t resolve then please see your doctor.
Impetigo is a highly contagious bacterial skin infection commonly occurring in young children. This skin infection is mainly caused by Staphylococcus aureus (S. aureus) bacteria. Treatment is typically topical antibiotic creams or oral antibiotics if creams are not effective. Antimicrobial resistance has become a worldwide concern and needs to be addressed when selecting treatment for impetigo patients.
If the impetigo infection is not healing with antibiotics, your doctor might take a sample of the liquid produced by a sore for testing. This will show what types of antibiotics would work best on it. Your doctor may refer you to a specialist doctor (dermatologist) for further tests. You will then be offered alternative treatment options.
The best ways to prevent impetigo is to stay clean and healthy. Other tips to avoid impetigo include:
- Keep hands clean: wash hands regularly. Use alcohol-based sanitizer if you don’t have soap and water.
- Practice good hygiene: clip your (and your child’s) fingernails regularly to avoid scratching. Sneeze into a tissue and then throw the tissue away. Bathe daily (or as often as possible), especially for children with eczema or sensitive skin.
- Avoid scratching: don’t scratch cuts or wounds. If your child gets a cut, scratch or wound, keep them from scratching it.
- Clean wounds: clean cuts, scrapes and injuries with soap and water. Then put an antibiotic cream or ointment on the wound.
- Keep linens clean: wash underwear, towels and sheets in hot water.
If you or someone you love has impetigo that is not healing with antibiotics due to resistance, you can find support here.
The NHS states the following with regards to bacterial vaginosis:
Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge. BV is not a sexually transmitted infection (STI), but it can increase your risk of getting an STI such as chlamydia.
BV is not a serious condition. Bacterial vaginosis is usually treated with oral antibiotics, gels or creams if symptoms are present. If you keep getting it (you get it more than 4 times in a year), you may be given an antibiotic gel that you put in your vagina. You may need to use this for a few months to help stop bacterial vaginosis coming back. Your GP will recommend how long you need to treat it.
Despite being used extensively, Group A Streptococcal (GAS) infections are not resistant antibiotics. Penicillin and amoxicillin are first-line antibiotics for GAS infection. However, doctors often use alternative antibiotics to penicillin, such as clarithromycin and azithromycin (macrolide antibiotics) to treat GAS infection, particularly for people who are allergic to penicillin. GAS infection responds well to first line antibiotics of penicillin and it is vital that antibiotics are started immediately if GAS infection is suspected.
It is important that antibiotics are taken correctly, for the correct infection and correct length of time in order to prevent antibiotic resistance to GAS infection. The following are ways in which you can prevent antibiotics resistance:
- Do not share your medication with others
- Take the medication exactly as your doctor tells you
- Do not save them for later. Talk to your pharmacist about safely discarding leftover medicines
- Do not take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects
- Talk with your doctor and pharmacist if you have any questions about your antibiotics prescribed to you
Further information on Group A Streptococcal infections and antibiotics can be found here.
The good news is, there are several different Strep treatment options for people with a penicillin allergy. Guidance from NHS England states children with penicillin allergy should be prescribed antibiotics belonging to a group called Macrolides. These include Clarithromycin and Azithromycin and are available in liquid form. The antibiotic course is usually 5 days in children.
It is important to discuss with your GP the type of penicillin allergy your child has and the nature of the reaction to penicillin. This will determine the choice of alternative antibiotic to penicillin your GP will prescribe. Local antibiotic guidelines may differ as to which particular antibiotic is prescribed. Make sure you discuss all the options with your GP to get the best treatment.
Further information on Group A Streptococcal infection can be found here.
You asked us to explain what Invasive Group A Strep (or iGAS as its sometimes called) is. It’s where a small proportion of (usually) children can develop an invasive infection. Bacteria enters the bloodstream and can cause sepsis or deep seated infections. Signs to watch for are:
- Persistently high temperature
- Pinkish or red body rash where the skin feels like sandpaper
- Strawberry tongue
- Drowsiness
- Not wanting to eat or drink
The recommended treatment for Strep A infections is a 10-day course of penicillin. The risk of developing iGAS is reduced the earlier the antibiotics are started.
Group A Streptococcal bacteria usually live in the mouth and nose. The bacteria are spread by coughing and sneezing. Droplets land on areas we then touch or if we are close enough to breathe them in. Some cause ‘Strep throat’ which feels like a sore throat. Others infect the skin through tiny cuts or sores, to cause impetigo or cellulitis. Strep A is currently being seen as Scarlet Fever in higher numbers of children than usually seen this time of year.
Scarlet fever is usually a mild infection but spreads easily. Symptoms to look out for include sore throat, headache, high temperature and sometimes a rash which has a sandpapery feel. This usually looks pink/red in colour but can be hard to see on darker skins. The NHS advice is to contact your doctor or NHS111/NHS24 if you suspect your child has scarlet fever.
Treating early with antibiotics is important to reduce the risk of developing into a more serious infection like pneumonia or a bloodstream infection which can be harder to treat. You are also advised to keep your child at home for 24 hours after starting antibiotics to avoid spreading the infection to others. You can find more information here.
Fabimycin is a new, man-made antibiotic found to kill hundreds of bacteria that are resistant to common antibiotics. Fabimycin is one of many tested compounds which successfully eradicated a range of gram negative bacteria including Klebsiella pneumoniae, E coli and even Acinetobacter baumannii.
However, it is still at the clinical trial stage in the USA. So, it is not available for prescribing in the UK yet. It has shown great promise in killing different types of resistant bacteria, but needs to go through human trials now. These will determine whether it can be used safely and effectively in humans.
It is safe to take Penicillin and Clarithromycin at the same time. Both these antibiotics work in different ways and are effective against different types of bacteria. As you are at a higher risk of developing an infection due to removal of spleen, it is important that you carry on taking Penicillin for this.
Antibiotic resistance can develop as a result of inappropriate use, prolonged courses of antibiotics and taking antibiotics incorrectly. Therefore, it is important that you take the Clarithromycin for the prescribed course length and at the correct times during the day. You can find more information on antibiotics resistance on Antibiotic Research UK website under the patient support section.
Vaccines are a great defence in preventing future antibiotic resistance. Many routine vaccines such as meningitis or typhoid, help prevent bacterial infections. If a person does not get the infection in the first place, then there is, therefore, no need to treat with antibiotics, hence reducing the amount of antibiotics that are used.
If you have started taking an antibiotic for an infection which testing subsequently shows you are unlikely to have, then it is sensible to stop that antibiotic. The risk of bacteria becoming resistant to antibiotics is increased the longer they are exposed to that antibiotic.
If the antibiotic isn’t needed, stopping it can limit exposure. This will hopefully prevent bacterial resistance developing.
If you are stopping taking your antibiotics early, you should then return the remaining pills to the pharmacy for safe disposal. Do not flush away or throw down the sink into the water system. This will also help reduce the risk of bacteria developing resistance within our environment.
Always consult your doctor before stopping antibiotics early.
Cellulitis is a skin infection caused by bacteria. It results in pain, swelling and discoloration to the area of infection on the skin. The discoloration, which can be red, purple or darker than the area of skin and looks like a rash, is caused by the toxins released from the bacteria. Flucloxacillin is a common treatment for cellulitis.
After a course of treatment has been completed and cellulitis symptoms have resolved, in some cases the rash or redness to the skin can remain. This is because it can sometimes take longer for it to go, even after the bacteria has been killed.
It is therefore important to seek advice about the rash or redness from your doctor. They will be able to access you and your symptoms. Then they can determine whether you still have an active infection or not.
Penicillin allergy is one of the most commonly reported drug allergies. However, around 95% of patients with a penicillin allergy label have not experienced a true allergic reaction. It is possible to test for a penicillin allergy to see if you are genuinely allergic.
It is important to be able to distinguish whether you have a true allergy to penicillin or are just experiencing side effects of penicillin. A true penicillin allergy has any of the following:
- Occurs immediately or within 1 hour of taking penicillin
- Hives
- Localised swelling
- Wheezing/shortness of breath
- Anaphylaxis
Side effects to penicillin are not true allergies and therefore should not be a reason for avoiding penicillin if it is required. The following are side effects to penicillin:
- Nausea/vomiting
- Diarrhoea
- Headache
- Vaginal itching
Penicillin allergy testing on the NHS is very rare unless it is carried out by a specialist. However new guidelines by the British Society for Allergy and Clinical Immunology (BSACI) have recently been issued about penicillin de-labelling for healthcare workers, so this is something that may become available routinely in the future. For further information on getting a test for penicillin allergy, speak to your doctor, pharmacist or contact the patient support service at Antibiotic Research UK.
The treatment offered for a UTI to people who are allergic to penicillin will depend on their history and nature of the reaction. It is recommended that they avoid all antibiotics belonging to the penicillin family. These include:
- Amoxicillin
- Ampicillin
- Flucloxicillin
- Co-amoxiclav
- Penicillin V (Phenoxymethylpenicllin)
- Penicillin G ( Benzylpenicillin)
- Piperacillin + Tazobactam (Tazocin)
- Temocillin
Furthermore, antibiotics belonging to the cephalosporin family should also be avoided. This class of antibiotics are closely related to penicillin. These antibiotics include:
- Cefalexin
- Cefuroxime
- Ceftriaxone
- Cefotaxime
- Ceftazidime
It is important that your doctor is aware of your allergy and also what happens when you take penicillin. This is very important when determining which antibiotics can be prescribed for you to treat your UTI without triggering an allergic reaction to penicillin.
For further information on penicillin allergy please refer to the patient support section, where you can find a patient support leaflet on this topic. We have lots support available for people who suffer with antibiotic resistant UTIs too.
Antimicrobial stewardship is a programme in a healthcare setting promoting the appropriate use of antibiotics. It also aims to improve patient outcomes and reduce the spread of multi-drug resistance organisms. Proper antimicrobial stewardship helps to reduce antimicrobial resistance and prevent a global health crisis.
The goal is:
- to use the RIGHT antibiotic
- for the RIGHT person
- at the RIGHT time
The primary goal of antimicrobial stewardship is to get the best clinical outcomes while minimising unintended consequences e.g. resistance and adverse effects of antimicrobials.
The time to take your antibiotics and whether you take them before or after food will depend on the type of antibiotic you are taking. Antibiotics that are taken at the incorrect time increase a patient’s risk of suffering from nausea, diarrhoea and vomiting. Taking them incorrectly can also increase your chance of developing antibiotic resistance.
In some instances, taking antibiotics with food may help to reduce stomach issues. These include antibiotics such as amoxicillin and doxycycline. Nevertheless, this approach won’t work for all antibiotic treatments. Some antibiotics, such as tetracycline or flucloxacillin, should be taken on an empty stomach.
- BEFORE food: Penicillin, Flucloxacillin
- AFTER food: Metronidazole, Trimethoprim, Doxycycline, Nitrofurantoin
- EITHER before or after food: Amoxicillin, Ciprofloxacin
It is also important to remember that certain foods may interact with particular antibiotics. You might have to avoid specific foods during your treatment and for some time after.
Some antibiotics are supposed to be taken at the same time each day. Others must be taken at set times so that the effect is spread out evenly over the course of the day. Always seek advice from your pharmacist if you are unsure of when to take your antibiotics or how to take them.
Staphylococcus aureus is a major cause of skin infection. A large number of strains are resistant to penicillin, such as flucloxacillin (1st line of treatment if no allergy) making this infection problematic to treat.
It is possible that your staphylococcus aureus skin infection can’t be treated successfully with flucloxacillin. If that is the case, get advice from your GP about getting skin swabs sent to microbiology. The results from microbiology will give alternative treatment options that the infection is most sensitive to. They may even give options that require you to have antibiotics in the hospital via the I.V. route.
For further information on skin infections, please refer to the Antibiotic Research UK, patient support page.
Using clarithromycin together with statins (called simvastatin) is not recommended. Combining these medications may significantly increase the blood levels of simvastatin. This can lead to liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue.
You should let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness. Always seek advice from your doctor when starting antibiotics. They will be aware of your medication history and prescribe antibiotics most appropriate for you.
One of the side effects to taking antibiotics is diarrhoea, this is because treatments can disrupt the balance of the ‘good’ bacteria in your gut which can lead to loose stools.
Antibiotic-associated diarrhoea is defined as having loose, watery stools three or more times per day during your treatment. This may begin about a week after starting antibiotics or, diarrhoea can also develop in the weeks after finishing your treatment.
Although all antibiotics can cause loose stools, some types are more closely associated with the condition. Antibiotics that have a higher likelihood of causing diarrhoea include:
- penicillin, such as amoxicillin and flucloxacillin
- cephalosporins, such as cephalexin
- clindamycin
You should contact your doctor urgently, if you’re taking antibiotics and have the following symptoms:
- more than five episodes of diarrhoea in a day
- blood or pus in your stool
- fever
- abdominal pain or cramps
For further information or questions on antibiotic associated diarrhoea, please contact the patient support team via the link:
https://www.antibioticresearch.org.uk/patient-support/find-support/
Most medicines should be stored at room temperature (around 20◦C). Most manufacturers suggest storing antibiotics below 25◦C. It is very important to read the labelling advice with regards to which temperature your antibiotics must be stored under. This is because some antibiotics lose their effectiveness when stored incorrectly and some may change form and become difficult to use.
Take a look at our tips for storing antibiotics in hot weather conditions:
- Not in the bathroom cabinet – bathrooms can be hot and humid, which could affect the stability of antibiotics
- In the coolest and driest place of your house
- Away from direct sunlight
- Kept in original packaging and containers
- Kept in airtight containers if it’s humid
- In an insulated bag if travelling in a car during hot days
If you think your antibiotics may have been exposed to higher-than-recommended temperatures, speak to your pharmacist for further advice.
According to the NHS, trimethoprim should not be taken if you have a history of anaemia. Furthermore, haemolytic anaemia is listed as a side effect of trimethoprim.
Haemolytic anaemia is a condition where red blood cells are destroyed faster than they are replaced. Although this is a rare side effect, it is important that you discuss this with your doctor. That way, appropriate antibiotic treatment can be administered.
Having a long-term catheter increases the risk of developing urinary tract infections (UTIs). The NHS advise the following to prevent contracting a catheter associated UTI:
- wash the skin in the area where the catheter enters your body with mild soap and water every day.
- wash your hands with soap and warm water before and after touching your catheter equipment.
- make sure you stay well hydrated – you should aim to drink enough fluids so that your urine stays a pale colour.
- avoid constipation – staying hydrated can help with this, as can eating high-fibre foods, such as fruit and vegetables and wholegrain foods.
- avoid having kinks or bends in the catheter. Make sure any urine collection bags are always kept below the level of your bladder.
UTIs caused by using a catheter are one of the most common types of infection that affect people staying in hospital. This risk is particularly high if your catheter is left in place continuously (an indwelling catheter).
Symptoms of a UTI associated with using a catheter include:
- pain low down in your tummy or around your groin
- a high temperature
- feeling cold and shivery
- confusion
Always speak to your GP or community nurse if you think you have a UTI, as you may need a course of antibiotics.
Advice from NHS is that “It’s a good idea to avoid drinking alcohol when taking medicine or feeling unwell. But it’s unlikely that drinking alcohol in moderation will cause problems if you’re taking the most common antibiotics. However, some antibiotics can have side effects such as feeling sick or dizzy, which might be made worse by drinking alcohol.”
Although modest alcohol use doesn’t reduce the effectiveness of most antibiotics, it can reduce your energy and delay how quickly you recover from illness. So, it’s a good idea to avoid alcohol until you finish your antibiotics and are feeling better.
Alcohol should be avoided when taking the following antibiotics:
• Metronidazole – drinking alcohol with metronidazole can cause very unpleasant side effects. You may experience feeling and being sick, stomach pain, or hot flushes. You may also have a fast or irregular heartbeat, headaches, feeling dizzy and feeling drowsy
• Doxycycline – alcohol can affect this medicine. It may also be less effective in people with a history of drinking heavily
Always ask your GP or pharmacist if you’re unsure whether you can drink alcohol while taking antibiotics.
Acid reflux can be a side effect of doxycycline. It is important that you take the antibiotic with a large glass of water. You should also sit upright for 30 mins after taking it. This can help reduce the side effects on the stomach.
Other side effects of doxycycline include:
Skin sensitivity to sunlight – it is important you take the appropriate precautions to protect your skin from sun damage. Cover your skin when outdoors and wear sunscreen. Sun sensitivity is a common side effect of antibiotics.
Headaches – make sure you drink plenty of water. Simple painkillers like paracetamol or ibuprofen are safe to take with doxycycline.
Nausea and vomiting – take doxycycline after a meal or snack to help prevent acid reflux. Avoid dairy products, like milk, cheese or yoghurt for a few hours before or after you take it.
A known side effect of taking antibiotics is vaginal thrush. Antibiotic treatments can also kill beneficial bacteria, leading to an overgrowth of yeast in the vagina. Vaginal thrush can cause pain and discomfort in that area. Furthermore, overgrowth of yeast/yeast infection can cause vaginal dryness which may also cause discomfort.
It is very important that you discuss your symptoms with your doctor or pharmacist. They can advise you about the most appropriate treatment. Treatment for vaginal thrush is available from pharmacies to purchase over the counter.
Methenamine is not an antibiotic but a urinary antiseptic. It can be useful in preventing recurrence of urinary tract infections.
Previous systematic reviews found it to be a possible option instead of antibiotics but stated more studies were needed. Long term, low dose antibiotics is the usual approach to prophylaxis in women with recurrent UTIs as recommended by national and international guidelines.
However, antimicrobial resistance has been directly linked to antibiotic consumption. So, development of non-antibiotic alternatives is important. A recent study published in March 2022 found that methenamine might offer an appropriate alternative. For some women with a history of recurrent UTI, it has been a helpful treatment.
Nitrofurantoin is an antibiotic commonly used for the treatment of UTI. It may turn your urine dark yellow or brown. This discolouration is normal and a known side effect that is not harmful. Your urine should return to its usual colour after you finish taking the antibiotic. You should always consult your doctor if you have any concerns relating to antibiotics and their side effects.
For further information on resistant UTIs please refer to the about antibiotic resistant urinary tract infections page here.
Ciprofloxacin belongs to a group of antibiotics called fluoroquinolones. Common side effects of ciprofloxacin include:
- feeling sick (nausea) after taking the tablets or liquid
- diarrhoea after taking the tablets or liquid
Very few people taking or using ciprofloxacin have serious side effects. You should stop taking ciprofloxacin and tell your doctor straight away if you have:
- muscle weakness, pain or swelling in your joints or tendons. This often begins in the ankle or calf, but could also be in your shoulder, arms or legs. It can occur in the first 2 days of taking ciprofloxacin or even several months after stopping. It is more common in children
- pain or abnormal sensations (such as pins and needles that do not go away, tingling, tickling, numbness or burning) or weakness in your body, especially in the legs or arms
- severe tiredness, feel anxious or very low in mood, or have difficulty sleeping or remembering things
- ringing in your ears (tinnitus), loss of taste, or seeing double, or have any other changes in your sight, smell, taste or hearing
- diarrhoea (perhaps with muscle cramps) that contains blood or mucus – if you have severe diarrhoea without blood or mucus for more than 4 days, you should also speak to a doctor
- a faster or irregular heartbeat, or heartbeats that suddenly become more noticeable (palpitations)
- sudden breathlessness, especially when you’re lying down
- swollen ankles, feet or stomach
- seizures or fits (this side effect can happen if you have epilepsy)
You should discuss the side effects with your doctor or pharmacist if you have any concerns as they will be aware of your medical history.
For further information on resistant UTI please refer to the ‘about antibiotic resistant urinary tract infections’ page.
We can split antibiotics into distinct groups. Which group they belong to will determine which bacteria they are most effective against. Bacteria that cause infection in the urine differ from bacteria that cause skin infections. This will mean that you may be taking two types of antibiotics at the same time to treat each infection.
Antibiotic resistance can develop with inappropriate use, prolonged courses and incorrect doses of antibiotics. However, it is important to treat infections with antibiotics when you develop them. Your doctor or pharmacist will be able to advise you if taking two types of antibiotics at the same time is okay. For further information on antibiotic resistance please refer to the ‘causes of antibiotic resistance’ section on the Antibiotic Research UK website.
Unfortunately, nausea and sickness is a common side effect of taking antibiotics. Having antibiotics via the IV route would not necessarily avoid this side effect. Furthermore, IV antibiotics are not without side effects and should only be used for severe infections that do not respond to oral antibiotics. The most common side effects of IV antibiotics include:
- Rash
- Itching
- Diarrhoea
- Redness at the site of needle
- Nausea/stomach upset
If the symptoms of nausea with antibiotics are severe, your doctor may prescribe anti-sickness medication to help with this. You should always seek advice from your doctor and discuss options that will help with the symptoms and control the side effects of taking antibiotics long term.
Oral thrush is a yeast infection that some people get after taking antibiotics. It is common to get yeast infections after this treatment as it also kills the healthy bacteria that keep yeast under control. This can lead to an overgrowth of the yeast that causes oral thrush even after your course of antibiotics is finished.
Here are some general tips the NHS recommends on how to prevent oral thrush:
- take care of your teeth: brush twice a day, clean your dentures, and go for regular check-ups even if you have dentures
- brush your gums and tongue with a soft toothbrush if you do not have any teeth
- sterilise dummies regularly – for babies
- sterilise bottles after each use – for babies
- rinse your mouth after eating or taking medicine
- go to regular check-ups if you have a long-term condition like diabetes.
If you have further question relating to antibiotics or antibiotic resistance, please contact our patient support team via:
- email: patient.support@antibioticresearch.org.uk
- phone: 07367784114
There are a few options available for bronchiectasis treatment. According to the National Institute for Health and Care Excellence (NICE) the usual course length for antibiotics taken orally is 7-14 days. This is longer than the usual course length of 5 days for a chest infection. The longer course length is usually used to prevent recurrent infections and admission into hospital for severe exacerbations.
Your doctor may also ask for a sputum sample to check whether the infection is caused by bacteria and to ensure that the correct antibiotic is being used to treat the infection.
You can find further information on respiratory tract infections in the patient support section of Antibiotic Research UK website. Please click on the link below:
The research on this is very limited. Reversal of antibiotic resistant infection is not simple, it involves changes within populations rather than individual people. Antibiotic resistance traits can be lost, but this reverse process occurs more slowly and can take a long time. Therefore, it is very important that antibiotics are used appropriately and only for bacterial infections.
You can find further information on antibiotic resistance and UTIs in the patient support section of Antibiotic Research UK website.
Please click on the link below:
There are multiple tests for a recurrent UTI your doctor might ask you to complete. If you are suffering from a recurrent UTI your doctor will ask for a urine sample which will be sent off to a microbiology lab for testing, to test which bacteria is causing the infection. The lab will test the sample against a number of antibiotics to check which antibiotics the bacteria is sensitive to, and then the most appropriate antibiotic can be prescribed to treat the infection.
Furthermore, if you are suffering from recurrent infections that your doctor thinks may be caused by an abnormality in your urinary tract, you may have an ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI). Please seek further advice from doctor who will be able to advise you best about which tests for your recurrent UTI are necessary based on your history and any medical conditions.
You can learn more about antibiotic resistant UTIs here. Plus, if you need additional help, please reach out to our Patient Support Service.
Sometimes, you may be prescribed a long course of antibiotics for treating your UTI. However, antibiotics should only be taken if there are signs of an active bacterial infection. It is important that urine samples are sent off for microbiology results, to see which bacteria is causing the infection and which antibiotics will be most sensitive to treat the infection.
Recurrent UTIs usually require longer courses of antibiotics as the infection tends to be more difficult to treat. The usual course length of uncomplicated UTI is 3 days. However, your doctor may prescribe a course length of 7 days for a recurrent UTI.
Governing bodies such as NICE and Public Health England have jointly published antimicrobial prescribing guidelines for a range of common infection topics, which include recommendations on the choice, dosage and course length of antibiotics. The guidance reminds prescribers to use the shortest effective course.
It is important that you seek advice from your doctor and ensure that urine samples are being tested routinely if you have a recurrent UTI. Antibiotic course length can differ and your doctor or specialist will be able to decide best what is appropriate based on past infections, your medical history and current symptoms.
If you have an antibiotic resistant UTI, you can find information and support here.
You asked us about hydroxychloroquine interactions with antibiotics, and our experts are here to help.
A recent Medicines and Healthcare products Regulatory Agency (MHRA) drug safety article has published that there is an increased risk of side effects on the heart when hydroxychloroquine or chloroquine is taken at the same time as certain antibiotics.
These antibiotics belong to a group of drugs known as macrolide antibiotics and include antibiotics such as clarithromycin, erythromycin and azithromycin. The MHRA advise “Seek urgent medical help if you have any signs of problems with your heart (for example, palpitations, fainting, chest pain, or unexplained breathlessness)”.
It is important to discuss the safety of taking any antibiotics at the same time as hydroxychloroquine or chloroquine with your doctor. This conversation must occur before starting antibiotics.
You have some options when it comes to the treatment of a frequent UTI. Generally, there will be 3 steps your doctor is likely to take when treating recurrent UTIs:
- Send urine sample for testing and treat infection with a short course of antibiotics.
- Trial preventative treatment with antibiotics, which usually involves low dose of antibiotics given for longer periods of time (months).
- Referral to a specialist (urologist) to investigate further for any underlying causes.
For further information on UTIs please view the patient support service on Antibiotic Research UK website under the specific infection section.
Flare up of COPD can be caused by a chest infection due to either bacteria or viruses. Therefore, it is important to send off a sputum sample for testing before starting antibiotics. If the infection is viral, then antibiotics will not be needed for treatment.
However, your GP will be able to advise you accordingly based on your sample results and symptoms, therefore it is always important to get advice from your GP or healthcare professional before starting antibiotics.
Find out more about what you can do to help prevent the spread of antibiotic resistance.
Phage therapy involves using a specific virus (phage) which can infect the bacteria itself. Currently, it is the view of our science committee that it is still experimental with no evidence-based clinical trials having been undertaken that gave a positive outcome. Phage studies have been conducted more widely in Eastern Europe but not so much in the UK and more clinical trials and research will need to be conducted before we can start to consider it as a treatment option for resistant infections.
You may or may not still have the infection after your UTI treatment. Often the symptoms may be due to residual inflammation as well as habits that formed during the urinary tract infection episode. Many patients report that they are still urinating more frequently than normal and notice this more before bed when they aren’t distracted by something else.
It is important that you get advice from your GP if you still have UTI symptoms after completing your antibiotic treatment. You may require further help if the infection is still present. Further testing maybe required so it is always important to seek advice from your GP.
You should never share your antibiotics with someone else. Different infections can be caused by different bacteria. For example, chest infections and urinary tract (water) infections are caused by very different infection, as are infections of cuts and wounds. Therefore, the antibiotics you are given for one infection might not treat the bacteria that cause your friend or family member’s infection. Some infections are also caused by microbes called viruses (e.g. coughs, colds and most sore throats) and antibiotics do not work against these. Taking antibiotics in this way can promote antibiotic resistance, which can make current and future infections more difficult to treat.
Don’t forget, the antibiotics were prescribed specifically for you and they may not be suitable for your friend or family member due to allergies, other medicines they might be taking, or other underlying health conditions. Instead of sharing your antibiotics, you can reassure them that your antibiotics might not be the right ones and they should see their community pharmacist for minor ailments, or see urgent medical attention from a GP, NHS 111, or urgent care if they are worried.
A rectal swab test is common practice in the UK and is nothing to worry about. Bacteria are naturally in your gut and help to digest food and form part of your immune system. However, these bacteria can also cause infections if they get into a different part of your body, such as urinary tract infections. Increased use of antibiotics causes these gut bacteria to become resistant to antibiotics. Normally, this causes no problem and is nothing to worry about – unless these resistant bacteria cause an infection.
The rectal swab test is a painless swab of your back passage. It shows if any resistant bacteria are living in your gut. If they are, health professionals will let you know and also given written information about it. Your healthcare team may also wear aprons and gloves and you may be moved to a single-occupancy room. This should not impact on the quality of care you receive. If you have any questions or concerns do not hesitate to speak to your healthcare team, or contact our Patient Support Service.
Please do not dispose of antibiotics in your household waste. Don’t pour them down the sink or flush them down the toilet either! This causes antibiotics to escape into the environment which can lead to antibiotic resistance developing in the soil, plants and animals.
If you do have any left over antibiotics, take these to your local community pharmacy. There, the pharmacist will dispose of them safely and free of charge.
Unfortunately yes, there is a connection between antibiotic treatment and sun sensitivity. Some antibiotics (and other medicines) can make you more sensitive to sun exposure. This can cause sun burn and rashes more easily than you normally expect. The most common antibiotic associated with this is doxycycline, which is used for chest infections, skin infections (cellulitis) including MRSA and pelvic inflammatory disease. The fluoroquinolone antibiotics, which include ciprofloxacin and levofloxacin, can also cause sun sensitivity, but less commonly so.
If you have been taking one of these types of antibiotics, protect yourself again sun exposure. Please try to stay out of the sun where possible to avoid any sunburn. Where this is not possible try to cover yourself with clothing. Wear a high factor sun cream (at least SPF 30) and reapply regularly.
Other sources of UV light can also cause sun burn more easily whilst taking these antibiotics. It’s recommended that you avoid using sun beds or UV lamps for other beauty purposes until the course has finished and the antibiotics are out of your system.
If you have any concerns, please talk to your doctor. They can offer additional advice on managing sun sensitivity during your antibiotic treatment.
Rashes can develop due to many reasons and might not be due to the antibiotic. If you develop a rash whilst taking antibiotics please discuss with the person who prescribed you them.
Please take note of where the rash has developed. Did it cover the whole of the body or was it restricted to a small patch? Was the rash painful or itchy? How long after taking the antibiotics did it start? Did you have other symptoms or feel unwell whilst you had the rash? If possible it can be useful to take a picture to show your doctor.
Antibiotic allergies can restrict the arsenal of antibiotics which can be used to treat infections and can sometimes mean that first-line treatment cannot be used. Discussing side effects or possible allergies with a healthcare professional can help to determine how likely the antibiotic was to have caused the rash and ensure safe antibiotic use in the future.
Long term use of antibiotics is associated with antimicrobial resistance, therefore it is very important to discuss this with your doctor.
Starting regular antibiotics for prevention of a UTI will depend on a number of factors, such as number of infections over a period of time, any other underlying health conditions, sexual history and microbiology results of your urine sample.
Your doctor may suggest trying other preventative methods before starting regular antibiotics. Your doctor will weigh up the benefits of taking the antibiotics versus the risk of resistance to antibiotics depending on individual symptoms and recurrence of infection, therefore it is important to seek medical advise if you are unsure of any ongoing symptoms.
If you have symptoms of UTI with a negative urine culture then this will need to be looked at in detail by your doctor. It can still be a possible urine infection that hasn’t been picked up on the urine test.
Your doctor may repeat the urine test or refer you for further examinations to find out the cause for your symptoms. Always seek medical advice from your doctor if you are unsure of ongoing symptoms.
If you’re suffering with an antibiotic resistant UTI, you have our sympathies. But, you are not alone. Our Patient Support Service is available to patients and their families to help them manage the ongoing condition. We offer a range of resources to give you answers and reassurance. Find out more here.
UTI treatments for men are often longer and more complicated than those for women. Because of how the male urinary tract system is naturally, when men get UTI they are classed as ‘complicated UTIs’. This means it is more difficult to treat UTIs in men and therefore requires a longer course of antibiotics compared to women. In most cases this is 7 days for men, 3 days for women.
It is always important to consultant your doctor about course length of antibiotics. Your treatment will be customised to your symptoms.
There are a few key risk factors that are common with recurrent UTI infections:
- Anatomy – Women are more likely to get UTI’s due to how their body is naturally making it easier for bacteria to get to the bladder and causing a UTI.
- Bathroom Habits – It is important to wipe from front to back after going to the toilet as this lessens the risk of bacteria moving from the bottom into the urethra (a tube which transports urine from the bladder to an opening).
- Sexual activity – Bacteria can spread more easily during sexual activity. Practicing good hygiene before and after sexual activity is also helpful.
- Other health issues – Having underlying health conditions or a suppressed immune system can make you more prone to bacterial infections. Certain conditions or disease groups can make you more prone to UTI’s such as:
- Diabetes
- Autoimmune disease
- Neurological disease
- Kidney or bladder stones
- Surgery to any part of your urinary tract
Misuse of antibiotics happens when a person is prescribed:
- the wrong antibiotic
- the wrong dose of an antibiotic
- an antibiotic for the wrong length of time
Talk with your doctor about the best treatment for you when you are prescribed antibiotics.
You can find out more about what you can do to prevent the misuse of antibiotics here.
We do not advise stopping a course of antibiotics early without first seeking medical advice from a professional. There has been a lot of research into how long antibiotic courses should be, to determine the shortest possible length of course needed to completely kill all bacteria.
If you are being treated for an infection, the kind of antibiotics your doctor prescribes and the length of the course should be based on the best evidence. Feeling better, or an improvement in symptoms, does not always mean that the infection has completely gone. Your doctor has had years of training and has access to the latest evidence – so always follow their advice.
The World Health Organization states:
“Evidence is emerging that shorter courses of antibiotics may be just as effective as longer courses for some infections. Shorter treatments make more sense – they are more likely to be completed properly, have fewer side effects and also likely to be cheaper. They also reduce the exposure of bacteria to antibiotics, thereby reducing the speed by which the pathogen develops resistance.”
Find out more about what you can do to help prevent antibiotic resistance here.
Yes, community Outpatient Antimicrobial Therapy (OPAT) service is a community team which delivers intravenous (IV) antibiotics (antibiotics via a drip) in a community setting as an alternative to inpatient care. It allows patients who are medically stable and whose only reason for admission or an extended length of stay in hospital is the requirement for IV antibiotic therapy to receive their treatment at home. The service offers a highly clinically efficient, cost effective and safe alternative to inpatient care. This service is provided locally by your local health authority.
C. diff or Clostridium difficile is a bacterium commonly found in the gut. Often when people are given antibiotics for an infection, most of the gut bacteria are killed except for C. diff which can grow in the gut to give rise to symptoms such as diarrhoea and sickness. Those most at risk are the elderly and those in poorer health. C. diff infection is normally treated with antibiotics such as vancomycin. Most people will recover with treatment but in extreme cases a Clostridium difficile infection can lead to hospitalisation and death (https://www.meht.nhs.uk/patients-and-visitors/infection-prevention/about-c-diff/).
It is important to follow these measures to alleviate any ongoing symptoms: make sure you finish the antibiotics prescribed for the infection; wash your hands with soap and water regularly and after you have been to the toilet; drink plenty of fluids to avoid symptoms of dehydration; do not take any anti-diarrhoea medication; wash surfaces and bedding regularly; do not share towels with anyone; stay at home for 48 hours after your symptoms have cleared up. You can find further information here: https://www.nhs.uk/conditions/c-difficile/
There are two flu vaccines available: one has four different viruses in it (the quadrivalent one) and one with three different viral strains (the trivalent one). The trivalent one also includes an additional ingredient (called the adjuvant) which helps boost the recipient’s immune response.
Therefore, older people over 65 who tend not to give such a strong immune response compared to younger people should have the trivalent vaccine.
Although you might think the quadrivalent one is the ‘better’ one, one of the four viruses it contains does not normally make older people ill, only younger people. It is therefore better for younger people to have the quadrivalent vaccine and older people to have the trivalent one with the adjuvant that helps the immune system work better. The ideal might be for everyone to get a quadrivalent one with adjuvant but that is not available. The pharmacist – or other clinic – will check your age and give you the right one.
UK poultry meat producers have stopped all antibiotic preventative treatments and the highest priority antibiotics that are critically important for humans are used only as a ‘last resort’ for chickens and turkeys. Between 2012 – 2019 there has been a 76% reduction in the use of antibiotics in the poultry industry.
If you are concerned about antibiotics being used in the poultry industry why not ask your supplier: have antibiotics been used in the rearing of my turkey?
Uncooked meat including turkey can be contaminated with bacteria such as Salmonella that can cause food poisoning. Here are some tips to avoid your Christmas break being spoiled:
1) don’t wash your turkey – contaminated splashes from the carcass might get on your hands and into your mouth
2) make sure you wash your hands, all containers, chopping boards and knives if they have been in contact with your raw turkey
3) make sure your turkey is cooked all the way through preferably by testing with a meat thermometer
4) if you have leftover turkey, keep it in the fridge after it has cooled down from the oven
5) if you freeze your turkey leftovers make sure they are thoroughly defrosted before reheating or to be used in a recipe
Probiotics and live culture yoghurts have often been promoted in preventing antibiotic-induced diarrhoea. However, the research data is conflicting. Some studies have suggested that using these products does treat the diarrhoea but equally others have not. The evidence that they can prevent diarrhoea when taken during a course of antibiotics is a little more convincing but still not conclusive. The jury is still out on this question!
Clostridium difficile (C. Diff) is a bacterial infection which causes up to 30% of antibiotic-associated diarrhoea with a wide spectrum of severity from a mild to life-threatening illness.
A fifth of cases are cured within 3 days by stopping the antibiotic. More severe Clostridium difficile infection cases will need specific antibiotic therapy and some will need repeat treatment.
It is highly infectious, especially in hospital and care-home settings. The elderly and those with significant underlying disease are most vulnerable. In these situations, strict basic hygiene practice often prevents the spread of infection between individuals.
Careful and effective use of antibiotics greatly diminishes the risk of this infection. Conversely, taking broad spectrum or combination antibiotics, prolonged and/or repeated antibiotic courses increase the risk of C. Diff. The use of acid suppressing therapy at the same time as antibiotics also increases the risk of acquiring a Clostridium difficile infection.
Diarrhoea caused by taking antibiotics occurs in up to a quarter of people. It is more common with some types of antibiotic, particularly broad-spectrum ones. It is due to an alteration in the balance of different bacteria in the gut.
Most cases are mild and self-limiting, stopping within a few days of finishing the treatment course, but sometimes you will need to stop the antibiotics and seek your GP’s advice. Make sure you drink plenty of fluids while you have symptoms. About 20-30% of cases are caused by Clostridium difficile infection which can be more serious.
Do you find yourself asking why your dentist won’t prescribe a antibiotics for toothache? It’s likely because toothache is often caused by tooth inflammation rather than infection. Analgesics such as paracetamol and ibuprofen treat inflammatory pain. Antibiotics do not fix the tooth inflammation so aren’t effective for treating toothache.
In some cases, you might have a bacterial infection associated with a dead tooth (a dental abscess). But, antibiotics are still not usually the right treatment. Antibiotics cannot easily get inside the tooth to the root of the infection. The quickest fix is usually to remove the source of the infection using a dental procedure. There are various ways to do this which you should ask your dentist about.
Even when a dental antibiotic is required to treat tooth pain caused by a severe infection, they should be used along with a dental procedure. Taking antibiotics unnecessarily increases the chance that they will not work for an infection in the future. If you were to suffer with sepsis or pneumonia in later life, you will need antibiotic treatment, so why risk antibiotic resistance today?
When you have tooth pain, visit your dentist so they can diagnose the cause. They’ll then offer the most effective solution for treating your toothache. Doctors in GP practices or A&E are not able to diagnose toothache and you are likely to be in pain for longer than if you see a dentist. If you don’t have your own dentist, call NHS111 and they will be able to help you find someone who can provide the care you need.
Antibiotic resistance can affect the health of both people and animals. In fact, many microbes (germs) do not recognise these types of boundaries, and the same bacteria, virus and fungi can be found in different types of animals, and humans. This includes our pets who can also get bacterial illness. So, sometimes your dog might need antibiotics. Veterinarians are becoming more focused on their use of antibiotics and significant improvements have been made by vets to reduce inappropriate use of antibiotics to decrease the risk of antimicrobial resistance in the future.
Antibiotic resistant bacteria that transfer from an animal to a human, is called ‘zoonotic’ – this just means it can adapt and survive on animals and humans. Therefore, it is possible for you to get a bacterial infection from one of your pets that is resistant to antibiotics. This doesn’t mean stop loving and caring for your pets – but it does mean that you need to take some additional basic hygiene precautions, including hand washing after touching the dog, and avoiding close contact when you are eating to reduce the risk of resistant bacteria passing from your dog and into your gut. Talk to your veterinarian if you are concerned.
Under no circumstances must you ever use medication intended for your dog, or vice versa. Even though the same types (classes) of antibiotics are commonly used on humans and animals, the doses, strength and duration will usually differ markedly.
Following a stem cell transplant you will have very low white blood cells (these are the blood cells that help fight infection and make up your immune system within the blood stream). This is due to the treatment you have had. When doctors or nurses say ‘new immune system’ they mean that your immune system needs to build up again i.e. building up the white blood cells within the blood stream to help fight infection. The time it takes can vary from person to person, but they may remain low for some time. Unfortunately, this means you may be more prone to getting infections. These infections/bacteria would usually cause no problem and are usually harmless to people with normal immune systems.
Methicillin Resistant Staphylococcus Aureus (MRSA) is a type of staphylococcus aureus bacteria that is resistant to many antibiotics. When resistant they can still live on your skin and up your nose and cause no problems or symptoms; this is called colonisation and can happen through:
• touching the skin of a person who is colonised with MRSA
• touching a contaminated surface like a door handle, phone or work surface
If your skin is colonised and you have an opening in your skin (when the barrier is breached) the bacteria are opportunistic and can enter the opening thus causing an infection. MRSA can also enter the bloodstream through medical procedures and devices like surgical incisions (cut to skin) or medical devices like a cannula (intravenous drip).
If you are found to be colonised with the bacteria, the doctor may prescribe skin washing with special soap for your body and/or cream for your nose. This treatment is called decolonisation.
If you have symptoms of the infection your doctor may prescribe antibiotics to treat it. If you have been told you have a collection of pus anywhere (like an abscess) the doctors may want to drain it (take the fluid out) or operate to remove it. Some infections can’t be treated with oral antibiotics (tablets or capsules) and need to be treated with intravenous antibiotics.
You can read Tony’s story about living with MRSA here.
Condensation remains arguably the largest cause of dampness in indoor areas, and can eventually lead to the growth of mould. If left unaddressed, condensation can also damage property by fraying curtains, peeling wallpaper and creating a generally musty environment.
The growth of fungi like mould, is probably a greater risk to the health of those living there than bacteria build up. There are some things you can do to try to reduce the risk of bacteria or fungal spores forming when drying laundry indoors. They include dehumidifiers, electric clothing racks for fast warm drying of clothes – but of course, involve investment. You can find ideas here.
The NHS website contains useful information about reducing the risk of germs spreading in all sorts of places.
It includes helpful information on laundering clothes too, such as:
- Wash your hands after handling dirty laundry
- All underwear, towels, and household linens should be washed at 60C (140F) with a bleach-based laundry product to prevent germs from spreading
- Don’t leave laundry in the washing machine – any remaining germs can multiply rapidly
The use of antibiotics has long been linked to deprivation of gut bacteria. Healthy gut bacteria are vital to help build up the immune system. So, in some cases, there is the cause for concern over immune system recovery times following a course of antibiotics.
One study shows that the makeup and function of gut bacteria can mostly recover after antibiotic treatment in healthy people. So, that means we are able to regenerate our gut bacteria and environment which is important for our general health. How long immune system recovery takes after a course of antibiotics depends on the person.
The concern, however, relates to potentially losing some of those beneficial bacteria permanently after multiple courses of antibiotics during our lifetime. We should therefore aim to minimise the number of antibiotic courses we take wherever possible. Make sure to only take antibiotics when absolutely necessary. There are lots of little changes you can make to help prevent further antibiotic resistance. We’re working hard to raise awareness for antibiotic resistance, create new treatments and support patients living with resistant infections.
Both vaccines and antibiotics and are very useful in helping us stay healthy. But, there are several key differences between vaccines and antibiotics that we think you should know.
Vaccines offer protection against potential future infection. They induce a protective immune response in your body. The specific, protective immune cells have a memory element to protect for any future infection by that particular virus. These memory cells allow for a quick response so that when exposed to that virus again. This means you are quickly protected and can avoid becoming ill.
Antibiotics are effective for eradicating bacteria but do not have any effect on viruses. Antibiotics are used when there is a current bacterial infection present. Inappropriate use of antibiotics is a growing concern globally now. Some bacteria have developed antibiotic-resistant strains, like Methicillin-resistant Staphylococcus aureus (MRSA), ESBL E Coli or Carbapenem Resistant Enterobacteriaceae (CRE). This means that certain antibiotics are now ineffective.
You can read more about drug-resistant bacteria here, discover how Antibiotic Research UK is tackling this problem, and learn a little more about bacterial vaccines here.
Blood poisoning or septicaemia are both terms which refer to the invasion of bacteria into the bloodstream causing severe infection. Sepsis is a rarer, but serious, complication of infection. It can lead to multiple organ failure and even death, sometimes without blood poisoning or septicaemia. The main cause of sepsis is usually bacterial infection, although sepsis can sometimes be due to fungal or viral infection (like COVID-19). You can find out more about sepsis here.
When someone gets infected with any general flu type virus, the virus can hijack the person’s immune system. As a consequence, that person is then susceptible to getting what is called a secondary bacterial infection. It is estimated that in general between 10 – 30% of patients with a flu type virus will get a secondary bacterial infection.
It is becoming increasingly clear that people who are weakened by COVID-19 are susceptible to contracting secondary bacterial infections. These can be acquired in hospital and are often resistant to treatment with antibiotics. You can explore the facts and figures published so far HERE.
COVID-19
Patients eligible to receive the NHS-funded flu vaccine should book their appointment. If you have recently had COVID-19, you can receive the flu vaccine when you’ve tested negative. You do not need to wait for the flu vaccine. However, if you are still feeling unwell due to suffering from COVID-19 despite a negative test result, it is best to speak to your doctor for further advice.
We understand why you might have concerns about having vaccines if you have a weakened immune system from treatments. However, advice from the NHS states that “it is safe to have the COVID-19 booster and flu vaccinations at the same time”. Since the COVID-19 vaccine does not protect against flu it is important that you have both vaccines to reduce the chance of becoming ill from either condition.
You may choose not to have both vaccines at the same time. It’s perfectly acceptable to have a gap between the two if you feel this is better for you due to your underlying chronic infection. It is best to discuss this with your doctor who will be able to advise you best according to your medical history.
Furthermore, if you are feeling unwell or experiencing a fever then as per manufacturer’s advice it is best to postpone having the vaccines. It’s important you seek further advice from your doctor about vaccines and your weakened immune system.
In today’s Ask ANTRUK, we’re looking at methotrexate and Covid-19 vaccine. The British Society of Rheumatology state “Immunosuppressed patients, as a result of medication or disease, are at high risk of severe illness from COVID-19. All patients should be encouraged to receive a COVID-19 vaccine, regardless of treatment regimen or underlying diagnosis. The benefits of the COVID-19 vaccination outweigh the risks. By having the vaccine, they reduce the risk of developing severe complications due to COVID-19.”
Some patients on immunosuppressive medication like methotrexate may not mount as good a response to the vaccine. However, studies are showing that the booster doses are enhancing the effectiveness of the vaccine in such individuals. Therefore, it is important that rheumatology patients have their booster doses.
It is important to discuss the timing of your COVID-19 vaccine, in relation to your methotrexate treatment with your specialist doctor or nurse to get further advice on when it is best to get the vaccine.
For general information on COVID-19 and antibiotic resistance, please read blog post on Antibiotic Research UK website:
https://www.antibioticresearch.org.uk/our-charity-coronavirus-covid-19-bacterial-infection-and-antibiotic-resistance/
Reinfection with the virus that causes COVID-19 means a person was infected, recovered, and then later became infected again. After recovering from COVID-19, most people will have some protection from repeat infections. However, reinfections do occur after COVID-19.
In October 2021, a study by the Yale School of Public Health, published in The Lancet Microbe reported that unvaccinated people should have immunity against reinfection for 3 to 6 months after they get COVID-19, but this research may not include new or novel variants of COVID-19. Because the length of immunity after developing COVID-19 or getting the vaccine is unknown, practicing physical distancing and wearing a mask need to continue to help stop the spread.
As COVID-19 rages on, the pandemic of antimicrobial resistance (AMR) continues in the shadows. The number of patients with an antibiotic resistant infection is rising across England, according to Public Health England some infections are rising by a third since 2015.
According to a recent article published in the Lancet, COVID-19 pandemic may have accelerated the problem of antimicrobial resistance due to antibiotic misuse or overuse and prolonged hospital stays. Moreover, antimicrobial resistance (AMR) surveillance has been deprioritised, with resources being used to help with the pandemic. Among the many consequences of the COVID-19 pandemic, AMR is one of the many consequential impacts it has had and will continue to have on our healthcare system and patients.
The Medicines and Healthcare products Regulatory Agency (MHRA) has continued their close surveillance of the vaccine roll out. They advise that individuals with a history of allergy or anaphylaxis to any food can receive any COVID-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine.
None of the currently approved UK COVID-19 vaccines contain any food proteins whatsoever. There is no reason to suspect that they would present any increased risk to individuals with an egg allergy. Always seek advice from your healthcare provider if you have any concerns about allergies with regards to the COVID-19 vaccine.
Yes, you should continue to take your antibiotics prescribed for UTI even while you have COVID-19.
Doctors prescribe antibiotics to treat a UTI, as it is a bacteria which causes the infection. COVID-19 is caused by a virus and not bacteria therefore antibiotics have no effect on treating COVID-19.
It is important that you complete the prescribed course for the treatment of your UTI. This ensures the infection is cleared and treated and reduces the risk of antibiotic resistance.
If you have coeliac disease, it’s natural that you are cautious about anything you put into your body, including the COVID-19 vaccine.
Gluten is a family of proteins found in certain cereal grains. The COVID-19 vaccines currently available do not contain gluten and are therefore safe to use in coeliac disease.
It is always important to seek advice from your local healthcare practitioner if you have any concerns about allergies or intolerances to the COVID-19 vaccine before having the vaccine.
Antibiotics work by killing bacteria. They do not work against viruses. Although antibiotics can kill the ‘good bacteria’ in your body, they do not work against your body’s immune response of making antibodies.
Hand sanitizer does not create antibiotic-resistant infections or contribute to the spread of antibiotic-resistant bacteria. The active ingredient in most hand sanitizers is ethyl alcohol (not antibiotics), which acts in a different manner than antibiotics.
When hands are visibly soiled, it is best to wash them with soap and water instead of using hand sanitizer, since it does not work as well when hands are dirty with particles (e.g., dirt).
Keeping hands clean, including with hand sanitizer, is an important way to prevent infections in individual people.
There is usually no reason to avoid having your COVID-19 vaccine or booster simply because you are taking antibiotics, from current evidence and manufacturers’ guidance. However, there are a few instances where you may wish to get advice on whether to wait to have your vaccination a little later. Where someone is experiencing current acute severe illness with fever, the information from all three manufacturers, Pfizer BioNTech, Moderna and AstraZeneca, states that vaccination should be postponed. It is always best to seek advice from your GP or healthcare practitioner if you have any concerns.
The COVID-19 booster vaccine is an additional dose of the existing COVID-19 vaccine, which is being given to the vulnerable and over 50s. The COVID-19 booster vaccine dose helps improve the protection you have from your first 2 doses of the vaccine. The COVID-19 vaccines are effective against the Delta variant and other strains as per manufactures’ information, providing you have both doses. As the booster dose is an additional dose, the aim is that it will help give you longer-term protection against getting seriously ill from COVID-19.
The COVID-19 vaccine does not protect against the flu as flu is caused by a different virus called the influenza virus. The COVID-19 vaccine is only effective against the COVID-19 virus and not influenza. So for protection against the flu you would have to get the flu vaccine in addition to COVID-19 if you are eligible as per NHS criteria.
Antibiotics are designed to help fight off infections caused by bacteria, therefore antibiotics do not lower your immunity. Antibiotics have no effect on viruses and since COVID-19 is caused by a virus it is safe to have the vaccine alongside antibiotics without there being any effect on how well the vaccine works in developing an immune response to the virus.
Yes, you can get a flu vaccine and the COVID-19 booster while on antibiotics. If your doctor invites you to get a vaccine, please go, even if you are taking antibiotics.
Research by the British Medical Journal reported “administering an influenza vaccine at the same time as a second dose of a COVID-19 vaccine produced no safety concerns and preserves the immune response to both vaccines”. Furthermore, The Department of Health has also stated that it is safe to have both the COVID-19 vaccine and flu vaccine at the same time. Some people may wish to have them on different days which is also ok.
Antibiotics are safe to take alongside both the flu and COVID-19 vaccines. Both vaccines trigger the body’s natural production of antibodies and stimulate immune cells to attack and neutralize the virus. Therefore, taking antibiotics will be unlikely to have an effect on the effectiveness of the vaccine. It will still be able to stimulate the immune system. Antibiotics are used to treat bacterial infections and have no effect on the virus or your immune response to the vaccine.
If you are feeling ill or suffering from any symptoms of an active infection, speak to your GP. Always speak to your doctor for specific advice.
Antibiotics work by targeting differences between bacterial cells and human cells. As a virus, COVID-19 lacks the components that antibiotics target therefore they are ineffective against the virus itself.
Some antibiotics have been studied to see if they can help patients with COVID-19. For example azithromycin, which is sometimes taken by those with chest infections and can also help to reduce inflammation, has been studied both in and out of hospital settings but has not been shown to help with COVID-19.
Occasionally some people later develop a bacterial infection whilst their body is fighting off the viral infection. This is called a secondary bacterial infection. Some people may need antibiotics to get them better.
If you are prescribed antibiotics for a bacterial infection whilst you have COVID-19 these will not affect the body’s ability to fight off the virus and can be taken to treat the other infection.
Low potassium diets may be recommended by healthcare professionals for several reasons but usually it’s in relation to kidney disease.
Medication can contain potassium, although this is usually in small amounts. The Pfizer vaccine contains a very small amount of potassium, less than 1mmol or 39mg per dose, which is classified essentially ‘potassium-free’. The other vaccines used in the UK (AstraZeneca and Moderna) do not list potassium as an ingredient.
Therefore it is unlikely that any of the vaccines available in the UK would need to be avoided if on a low potassium diet.
For more information on the vaccines available in the UK please visit the NHS website.
No, taking antibiotics will not affect covid test results. Tests for COVID-19 work by looking for the presence of certain parts of the virus itself. These are unique to COVID-19 and therefore confirm it is there in the sample.
Antibiotics only work against bacteria (germs) and not viruses like COVID-19. Therefore, taking antibiotics will not affect the levels of virus in the body or interfere with a test. This page explain a little more about how antibiotic treatments work, check it out.
You can read more about the tests and how they work on the Royal College of Pathologists website here.
I have recently received my COVID-19 vaccine. Can I still get COVID-19 despite having the vaccine?
Public Health England state the following:
The COVID-19 vaccine that you have had has been shown to reduce the chance of you suffering from COVID-19 disease.
It may take a few weeks for your body to build up some protection from the vaccine. Like all medicines, no vaccine is completely effective, so you should continue to take recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but this should be less severe.
Antibiotics should not affect your COVID-19 test. Antibiotics are effective against bacterial infections and don’t treat viruses. COVID-19 is a virus and so the viral antibody test targets antibodies against the spike protein, therefore you can still be tested for COVID-19 antibodies when on antibiotics and it should not interfere with the result.
Yes, it is still ok to have the COVID-19 vaccine if you have a penicillin allergy. Allergy to penicillin is not a contraindication as per the manufacturer information for the Pfizer/BioNTech or AstraZeneca COVID-19 vaccine or Moderna vaccine.
If you’re concerned about any allergies and the COVID-19 vaccine, speak to your doctor. You can find lots of information about COVID-19, secondary infections and antibiotics online here.
Allow at least 7 days between having the shingles vaccine and the COVID-19 vaccine.
The manufacturers’ information for the Pfizer/BioNTech, AstraZeneca and Moderna COVID-19 vaccines is as follows:
“It should not be routine to offer appointments to give this vaccine at the same time as other vaccines. Scheduling should ideally be separated by an interval of at least 7 days to avoid the potential of adverse events.”
If you have any concerns, please contact your doctor. Our Patient Support Service is also available for people managing resistant infections.
The British Society of Rheumatology have given this advice from Arthritis and Musculoskeletal Alliance (ARMA)
“There are some general principles but in each case the benefits and risks should be discussed with the patient to arrive at a shared decision”.
It is safe to have the COVID-19 vaccine alongside steroids, but the patient may not have such a good immune response. The vaccine should not be delayed for someone who is taking, has received or is soon to receive steroids in any form. It may be appropriate to delay a non-essential steroid injection, as part of a shared decision, so that the response to the vaccine is more effective. In this scenario, the steroid injection should be delayed by two weeks after the vaccine, to enable the patient to get the best response to the COVID-19 vaccine.
The vaccine is intended to stop you getting COVID-19 infection, which should then reduce the likelihood of you spreading the infection by becoming ill. Since the vaccine is still relatively new, it is not yet known if vaccination prevents the virus being carried in the nose and throat of people who have been vaccinated.
As the vaccination programme is rolled out more widely, the impact of vaccination on the spread of the virus spread will be better understood. The best way to avoid catching or spreading the virus is to have the vaccination when invited to, and keep following measures to reduce spread like social distancing, hand and respiratory hygiene and face coverings where advised.
It is important to have both doses of the vaccine to give you the best protection. The first dose of the COVID-19 vaccine should provide high short-term protection against severe disease for a duration of around 12 weeks while the second dose gives a more durable and longer protection against COVID-19. It can be assumed that protection from the first dose will wane in the medium term, and the second dose will still be required to provide more longer lasting protection.
You need both doses to give you the best cover and protection from COVID-19. The first injection prompts your body to begin producing an immune response, whereas the second dose helps your body to boost its immune response to the virus. You need both doses for best protection. It is also important to give your body enough time to build this immune response, so protection is not immediate. It can take a week or two for your body to produce that immune response, and so you should still follow the advice around social distancing and hand hygiene etc.
Knowledge about COVID-19 is still growing and we don’t yet know if having infection with COVID-19 means you’ll have long-term immunity particularly to variants. So, you should still attend for your vaccination even if you have previously tested positive for COVID-19 or for COVID-19 antibodies. However, you should postpone your COVID-19 vaccine for four weeks from symptoms of COVID-19 starting, or from testing positive for COVID-19 even without symptoms.
You should go ahead with the vaccine, provided you or the person self-isolating has no COVID-19 symptoms or had a positive test. There are only a few instances where someone should not proceed to be vaccinated, such as a high temperature, or febrile illness.
However, if the person self-isolating in your household develops symptoms of COVID-19 or tests positive, then this would change the position. You would then need to self-isolate too, for the required length of time and postpone your vaccination. The vaccination centre would not wish to vaccinate anyone with possible symptoms of COVID-19 or to risk spreading the virus within the vaccination centre. The vaccine takes a few weeks for your body to build an immune response so it does not provide immediate protection.
It is still too early to say if the current vaccines will work on the different COVID variants. The Kent variant (B.1.1.7) is now the main virus being identified in the UK and is more transmissible than the original UK virus found in February 2020. It appears that the Oxford / AstraZeneca and Pfizer / BioNtech vaccines are effective in boosting immunity against the Kent variant. We will update as new information becomes available.
For viruses, the term mutant means that the RNA sequence (genetic message for the virus) has undergone a change (mutation). The resulting virus with the mutation is called a variant, eg. you will hear about Kent variant, South African variant, Brazilian variant. Each of these variants have different mutations. Mutations occur in every living organism including humans, viruses and bacteria (antibiotic resistance is caused by mutations).
There is usually no reason to avoid having your COVID-19 vaccine (jab)) simply because you are taking antibiotics. However, where someone is experiencing current acute severe illness with fever, the information from manufacturers state that vaccinations should be postponed.
Public Health England’s Immunisation Against Infectious Disease (the Green Book) also states that minor illnesses without fever or systemic upset are not valid reasons to postpone immunisation. Individuals who are acutely unwell can have their immunisation postponed until they have fully recovered. This is to avoid confusing the differential diagnosis of any acute illness (including COVID-19) by wrongly attributing any signs or symptoms to the adverse effects of the vaccine.
COVID-19 vaccines trigger the body’s natural production of antibodies and stimulate immune cells to attack and neutralize the virus and hence protect against COVID-19 disease. This is why antibiotics will be unlikely to have an effect on the effectiveness of the vaccine to stimulate the immune system. Antibiotics are used to treat bacterial infections and have no effect on the virus or your immune response to the COVID-19 vaccine.
You can read more about bacterial infections here: https://www.antibioticresearch.org.uk/about-antibiotic-resistance/bacterial-infections/
You can discuss vaccine concerns with the health professional administering your vaccine.
If you wish to download and print a copy of this question and answer click HERE. If you are on antibiotics then show this advice to your vaccinator.
Further reading
Read more details about the vaccines in these external links:
The Oxford / AstraZeneca vaccine induces a strong immune response in the over 65s and is safe. The vaccine has been registered for use by the UK regulatory body, the MHRA as well as the central European regulator the EMA to be administered in anyone over the age of 18. A strong immune response indicates that the vaccine induces the production of antibodies that target the virus. It is not known currently if the other arm of the body’s immune system, memory T-cells are induced by COVID-19 vaccines.
Clinical trial data suggests that the Pfizer / BioNTech vaccine doses should be spaced out by 3 weeks i.e. dose one followed by dose two 3 weeks later. The AstraZeneca / Oxford vaccine has limited data suggesting that a longer period than 3 weeks between doses may be preferable.
No further trial information is available yet to give decisive answers on this.
Sadly there are very few vaccines for the treatment of bacterial infections and much more research is needed for this too.
The first indicator we will see is likely to be a reduction in the number of deaths in hospital from COVID-19. Current data suggest that around 75% of deaths from COVID-19 have been in the over 75 age group. You can read more here.
Assuming COVID vaccines are 70% effective on average then death rates should reduce by approximately 50%. This will hopefully be followed by a decrease in numbers of people requiring admission to hospital with this virus. Sadly, there are very few vaccines for the treatment of bacterial infections and much more research is needed.
Ideally a 7-day gap should be left between your COVID-19 and flu jabs so any adverse reactions or side-effects can be linked to the correct vaccine.
However, NHS England says they have updated this advice so other vaccines (like flu) can now be given at the same time as COVID-19 vaccines especially if there is a danger of delay, reduced access or the person not returning for the other vaccine. This is particularly aimed at care-home residents, housebound patients, hard-to-reach or vulnerable groups.
It seems that a few people are naturally immune to COVID-19. These people mount a T-cell response, indicating they may previously have been exposed to another virus of the coronavirus family such as SARS or MERS. T-cells are white blood cells which work in several different ways to help protect us from diseases like COVID-19. They form a part of the body’s immune system. T-cells kill infectious agents including viruses and bacteria by sometimes attacking the infection directly or the infected human cells.
T-cell response could also help to explain why some people recover relatively quickly from COVID-19. Others, with lesser T-cell response, continue to suffer chronic after-effects for months following infection. You can read more about the role of T-cells here.
The main reason that this virus is so infectious is because humans have never been exposed to this particular virus before – it is completely new and they have no immunity. In other words, as the virus enters the human body, the body has no pre-existing defences since it doesn’t recognise the COVID-19 virus as a dangerous intruder.
No – flu (influenza) and COVID-19 are both contagious respiratory illnesses, but they are caused by completely different viruses. COVID-19 is caused by a new coronavirus called SARS-CoV-2, whereas the flu vaccine provides protection against three or four influenza viruses that are expected to be the most common during the forthcoming winter.
However, it is worth having the flu vaccine if eligible. It will reduce the risk of acquiring flu and developing complications which can arise (such as pneumonia). It will also reduce the likelihood of suffering both viral infections at the same time which research shows can leave you more seriously ill.
Flu symptoms seems very similar to coronavirus. How can I tell if I have COVID-19 or just the flu?
It could be difficult to know if you have flu or COVID-19, based on symptoms alone as many are similar, e.g. fever, headache, sore throat, fatigue, aches and pains. The most predominant symptoms in COVID-19 are fever, dry cough and new loss of taste and/or smell. If you have any of these symptoms or suspect you could have COVID-19 you should follow the advice to self-isolate, book a test, and stay in isolation until you get results. Then follow instructions if the COVID-19 test result is positive.
Flu (also known as influenza) tends to affect the whole body and can lead to complications such as pneumonia in vulnerable people. For this reason, many more flu vaccinations are being made available free through the NHS this year, to protect a greater number of people and especially those in more vulnerable groups. You can find more information about getting a flu vaccine here.
A concerned mother contacted Ask ANTRUK about her daughter who is taking penicillin and a negative COVID-19 test result. She wrote:
My daughter is on penicillin for tonsillitis. She has had a negative COVID-19 test result which is surprising. My son is positive for COVID-19 and she has all the COVID-19 symptoms. Is it possible that being on penicillin has produced a false negative result for COVID-19 when it should have been positive?
Our experts answered:
It is highly unlikely that the penicillin has interfered with the COVID-19 test as it only affects bacteria, not viruses. However, experts are publishing more information about the specificity and sensitivity of COVID-19 tests. That essentially measures how accurate the testing is. Recent information suggests that there can be reasonable incidence of false negative tests occurring in those who actually have COVID-19.
A BMJ article has reinforced a key message that “a single negative COVID-19 test should not be used as a rule-out in patients with strongly suggestive symptoms”. The more important action is to isolate and follow the usual guidance if you believe she (or anyone in the household) has COVID-19 symptoms.
As far as current knowledge allows, taking a antibiotics for a UTI should not affect the test for COVID-19.
The COVID-19 test looks for particles of a virus. The antibiotics you are taking treats your bacterial infection. The two are quite different and should not interact. You can read more about COVID-19 testing here. You can always ask your doctor about any concerns you have. If information changes, we will update this page.
T-cells are cells in the blood that provide a further way of attacking the virus. There are three ways viruses can be attacked two of which are through antibodies, but the other is through T-cells. T-cells attack cells in the body that contain the virus or may even attack the virus directly. Memory T-cells are T-cells that have a memory of a previous infection and spring into action if the body encounters a virus from a previous infection.
It may be that T-cells provide a long-term way of fighting COVID-19 infections since it appears that the antibody response to the infection may be short-lived (weeks to months). T-cells on the other hand may be active for much longer. If COVID-19 vaccines are to be successful they need to produce not only an antibody response but also T-cell immunity.
Unlike for antibiotic resistant bacteria, home based tests for COVID-19 are nearing general release to detect either the virus or antibodies to it. A number of tests are being evaluated to detect active viral infection using saliva rather than swab samples.
Antibody detection tests to see if you have antibodies against the virus will also soon be available. These will require a pin prick of blood which is placed on the device and lets you know if you have antibodies. We do not yet know if you have antibodies that you will be immune to viral infection.
Children and COVID testing are hot topics. But, if your child shows any of the symptoms of coronavirus, you should still have them tested.
Now that children are back to school in the UK, it’s important that you follow the guidance. If you have any of the main symptoms of coronavirus: get a test to check if your child has coronavirus as soon as possible. Keep them off school, stay at home and do not have visitors until you get their test result – only leave your home to have a test. Anyone you live with, and anyone in your support bubble, must also stay at home until they get their result.
There are 7 strains that can affect humans; 4 of these strains are the common human coronavirus that cause mild upper respiratory type symptoms – cold like symptoms. The 3 other coronaviruses cause more serious lower respiratory symptoms. They are known as MERS-CoV, SARS-CoV and SARS-COV 2 (COVID-19).
The first case of coronavirus was discovered in the mid-1960s. There are seven strains that can affect humans. Four of these strains are the common human coronavirus that cause mild upper respiratory type symptoms – cold-like symptoms. The three other coronaviruses cause more serious lower respiratory symptoms. They are known as MERS-CoV, SARS-CoV and SARS-COV 2 (COVID-19).
In an ideal world, they would want to know which bacteria a patient is infected with and give the most appropriate antibiotic known to treat that bacterial species. Without this information, clinicians are left with administering a broad-spectrum antibiotic in the hope that it will kill whatever bacteria are causing the infection.
Broad-spectrum antibiotics are active against a wider number of bacterial types and, thus, may be used to treat a variety of infectious diseases, especially when the infecting agent (bacteria) is unknown. The antibiotic choice is usually guided on what symptoms and severity of illness the patient presents with.
For example, If the patient has respiratory symptoms they would treat for a respiratory tract infection with antibiotics that are more targeted for that type of infection. Doctors monitor bloods, observations (BP, temp, respiratory rate, etc.) for improvement and take guidance from that.
There are very few reports which record the frequency of secondary bacterial infections such as bacterial pneumonia. In a large meta-analysis, (that’s where data from a number of studies is combined and analysed) numbers of around 7% were reported (details here).
On the other hand, anecdotal evidence during the current COVID-19 pandemic from two English large city hospitals suggest a figure of around 20 – 30%. However, because of our inability to obtain this information in real time, we won’t ever know exact numbers of patients affected with a secondary bacterial infection following a COVID-19 infection.
Some patients with severe COVID-19 symptoms can develop sepsis very quickly. To try and prevent such patients going into septic shock, empiric antibiotics are given without knowing whether the patient has or has not got a bacterial respiratory infection.
Until rapid bedside diagnostic tests are developed for determining if the patient has a bacterial infection and if so which organism, the clinician has no choice but to give empiric antibiotics. You can read more here on the subject.
Antibiotic prophylaxis is the use of antibiotics (usually) before surgery, to prevent a bacterial infection.
Empiric antibiotic therapy is often given to patients who have an unidentified proven or suspected infection. The responsible organism(s) or bacteria have not yet been confirmed, but treatment is required.
Current evidence does not suggest that having excess weight increases people’s chances of contracting COVID-19. However, a recent report from Public Health England confirms that you would be at more serious risk of severe illness or even death if you did contract COVID-19 and were excessively overweight or obese.
Being severely overweight puts people at greater risk of hospitalisation, being admitted to Intensive Care Units (ICUs) and death from COVID-19, with that risk rising as body mass index (BMI) increases. People are therefore being encouraged to move towards and maintain a healthier weight. You can read more here.
You can calculate your own BMI here.
No, you should not wear a mask while exercising. The WHO says you shouldn’t wear one when exercising as masks may reduce the ability to breathe comfortably. The mask could become wet more quickly as a result of sweat, which can make it difficult to breathe and could cause the growth of micro-organisms. Maintaining social distance from others during exercise is the most important preventative measure you can follow.
No – you will not get pleurisy, an inflammation of the tissue around the lung, by wearing a face mask for too long. There have been several other myths like this in circulation during the COVID-19 pandemic. Many myths around masks and carbon dioxide and oxygen levels have been spread too.
The WHO says that while the prolonged use of medical masks may be uncomfortable, it does not lead to breathing in too much of your own carbon dioxide, nor cause oxygen deficiency. However, you should not re-use disposable masks, and make sure you change it if it becomes damp.
The most important thing to know about coronavirus on surfaces is that they can easily be cleaned. Common household disinfectants will kill the virus. Studies have shown that the COVID-19 virus can survive for up to 72 hours on plastic and stainless steel, less than 4 hours on copper and less than 24 hours on cardboard. Always clean your hands with soap and hot water or alcohol-based hand sanitiser and avoid touching your face.
Scientists have attempted to answer this question by studying the transmission dynamics of other human coronaviruses and by analysing the effect of weather on COVID-19. Firm conclusions are not yet possible but initial studies suggest that coronavirus transmission is likely to be more frequent during the winter months.
Several dogs and cats (domestic cats and a tiger) in contact with infected humans have tested positive for COVID-19. In addition, ferrets appear to be susceptible to the infection.
In experimental conditions, both cats and ferrets were able to transmit infection to other animals of the same species. But, there is no evidence that these animals can transmit the disease to humans and play a role in spreading COVID-19. COVID-19 is mainly spread through droplets produced when an infected person coughs, sneezes, or speaks.
There are two main types of pneumonia: bacterial and viral. As COVID‑19 pneumonia is caused by a virus, antibiotics are ineffective to prevent or treat. However, pneumonia can arise due to a secondary bacterial infection, and antibiotics may be prescribed when serious and/or it is unclear whether the pneumonia is bacterial or viral in origin.
The pneumococcal vaccine offers some protection against what could turn out to be deadly pneumococcal infections. It is available to at-risk patients including babies, adults over 65 and those who have heart or kidney conditions. Unlike the flu vaccine, adults don’t have to have the jab every year and your GP will contact if they think you need one.
What happens to coronavirus patients in ICU will vary depending on the individual patient’s needs. In COVID-19 people are commonly transferred to intensive care due to low oxygen levels, requiring additional support to ensure enough oxygen is delivered to the body’s vital organs and tissues. In this situation patients may require intubation and mechanical ventilation.
Sometimes, other methods of assisting breathing are used such as non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP). This doesn’t always need to be done in an ICU environment, it depends on how stable the patient is and how they respond to the treatment. Turning patients onto their front (known as ‘proning’) is also often used to improve oxygen levels.
Occasionally, patients may require support of other organs, such as the kidneys, or medications given intravenously if blood pressure is dangerously low. Other treatments include administration of adequate nutrition and fluid, sometimes administered via a tube that goes from the nose into the stomach (an NG tube) if they are unable to take in adequate nutrition orally.
All patients in intensive care are closely monitored by the doctors and nurses on the unit, so that they can respond quickly to their individual needs.
Where treatments and procedures are essential, hospitals are ensuring that these patients are treated in areas well away from COVID-19 patients, and extensive hygiene and infection control practices are applied (see your hospital website or call the admissions office for more information).
Since you and your family members are all considered to be at higher risk than the general population, you may wish to discuss with your GP the benefits of going ahead with the cystoscopy and measure that against the potential risks to you and your family.
This is a difficult but very important decision you have to make, and you should be guided by your healthcare team in reaching that. You can read more about ‘shielding’ HERE, and the advice that has been given about protecting yourself from catching COVID-19 during this time.
A ‘cytokine storm’ refers to the overproduction of inflammatory proteins. These inflammatory proteins are an important part of the immune response (the body’s response to infection). However, in a cytokine storm the overproduction of these proteins are harmful.
Sepsis is defined as life threatening organ dysfunction caused by a dysregulated host response to infection. When we hear sepsis being talked about in the news, this is often referring to bacterial infection as the cause of sepsis. However, the cytokine storm that we see in COVID-19 can be thought of as a type of viral sepsis. In addition, it is possible that secondary bacterial infections may develop when the body’s immune system is weakened from fighting the viral infection.
Like any other surface that large numbers of people come into contact with, notes can carry bacteria or viruses. However, the risk posed by handling a polymer note is no greater than touching any other common surface, such as handrails, doorknobs or credit cards.
It is therefore important to think about all other money related surfaces you come into contact with which may have the virus on them. Follow a good hygiene procedure, such as sanitising hand wipes and hand washing, after handling any money.
Sepsis is a life-threatening reaction to an infection. It happens when your immune system overreacts to an infection and starts to damage your body’s own tissues and organs. The overreactive immune response causing sepsis can be triggered by any infection, bacterial or viral, including COVID-19.
The majority of COVID-19 patients experience mild symptoms. However, some patients are admitted to hospital because they have a more serious illness which may include breathing difficulties. As there is no treatment for COVID-19, they are given supportive care which aims to maintain the function of the body’s vital organs to keep the individual alive while the disease progresses and eventually resolves.
Treatments involves providing the patient with supplementary oxygen via nasal tubes or face masks or in the sickest patients using a mechanical ventilator in ICU. Complications such as hospital-acquired bacterial infections of the chest, urine or bloodstream are common during treatment in ICU, which further increase the chance of the patient dying.
As COVID-19 is a new disease we still do not know the long-term effects. There is active research into this area but the results will not be available for some time. We know from experience with other diseases that people with critical illness requiring a long term stay in intensive care can experience long term consequences, such as psychological effects including anxiety, depression and post traumatic stress disorder.
There may also be long-term effects on organ function such as kidney and lung function; and muscle wasting and weakness following COVID-19. It is important to note, however, that not everyone requiring intensive care admission will experience these long term consequences.
The virus test detects active infection and works best during the first seven days of symptoms. The virus can be detected in a COVID-19 swab taken from the nose or throat, even before symptoms of illness first appear. This is why people can be infectious for a few days before the onset of symptoms, which usually appear about 5 days after the virus infects.
Some people have no symptoms throughout their infection but are positive on the virus test and infectious to others. After a few days of illness the concentration of the virus falls (as seen in COVID-19 swab samples) and the symptoms of the illness usually recede, while the level of antibodies in the blood goes up.
Repurposed drugs are drugs that were developed for treating one disease but are used to treat another. For example a drug being developed to treat diabetes was found to kill drug resistant bacteria.
The hope with COVID-19 is that an existing drug can kill the virus and therefore be used to treat infected patients. There are approximately 1500 drugs in total – our charity has screened all these and found 10 drugs worth investigating further (see article here). Using existing drugs or combinations means that clinical studies can be undertaken quickly.
Co-amoxiclav is used to treat bacterial infections. It is an antibiotic treatment that has proven useful in treating secondary bacterial infections in COVID patients.
Antibiotics do not treat any viruses, including Coronavirus. However, they are absolutely essential for treating bacterial infections. Some bacterial vaccines do exist to protect against certain bacterial infections. They are very useful for treating patients who have a weak immune system or medical condition.
Patients with COVID-19 are also very susceptible to secondary bacterial infections. The only treatment for these infections are antibiotics. It may be that your family member had developed a secondary bacterial infection that required co-amoxiclav treatment.
There is a current trial investigating the impact of vitamin C in critically ill patients with COVID-19 in China, however we will not have the results of this for a number of months. There is currently not enough evidence to recommend vitamin C as standard treatment or prevention of COVID-19.
Some companies are selling home based antibody test kits. The UK health authorities have cautioned against people buying and using these kits (more info here).
You cannot be sure the results you receive are accurate and reliable. So current advice is do not buy home based antibody test kits until there are some which are validated and certificated by the UK government. Sadly, rapid diagnostic test kits for antibiotic resistant bacterial infections are not available either for home or hospital use. This is an area that also needs focus and investment to improve patient care.
You can read more about test kits here.
The COVID-19 swab test is used to detect if you currently HAVE the virus. It is done by taking a swab sample from your mouth and sometimes your nose too. This test is then it’s sent off to a specialist lab. These samples can also be taken at home but all samples must be sent to a government approved lab for analysis to ensure results are accurate and reliable.
An antibody test is a different type of test which looks for the presence of antibodies produced by the body when someone contracts COVID-19. This test can tell if a person HAS previously been infected at some point.
You can read more about tests here.
People from the Black Asian and Minority Ethnic (BAME) community seem to be more at risk of severe illness and death than white social groups. This may be due to greater exposure to COVID-19 in the type of work they do or living situation, or it may be linked to underlying health conditions such as heart disease or diabetes.
Currently the increased risk has not been fully explained and the reasons are under investigation in further research studies. You can read more on the topic here.
It is possible that anyone with underlying health conditions such as COPD or a heart condition will be more adversely affected by COVID-19. The current guidance for patients such as these is to self isolate. See the NHS advice for high risk patients.
There are no specific home treatments for COVID-19 (the disease caused by the Coronavirus). If you catch it, make sure to get plenty of rest and fluids, and use paracetamol to treat the fever.
Antibiotics do not work or protect you from viruses. So, you should ensure you have some paracetamol which works better than ibuprofen. Keep warm and take in lots of fluids. It’s important to watch for any deterioration like breathing difficulties.
See the NHS websites for emergency numbers and information.
The NHS says that “Children can get coronavirus (COVID-19), but they seem to get it less often than adults and it’s usually less serious.”
However, like any other group in society, they can spread the virus, even if they are not displaying obvious symptoms. Schools should be following the Government’s “Coronavirus (COVID-19): guidance for schools and other educational settings” guidelines, which cover safe-distancing and managing the dangers of transmission.
If your children exhibit any of the symptoms of COVID-19, please visit here for help and advice.
If you are worried that you are more vulnerable it is worth speaking to your GP. You might also consider self isolating to shield you from the risk of catching the COVID-19. Anyone who is immuno-suppressed is considered to be at more risk from COVID-19. However, these are usually people treated with drugs which suppress the immune system. Antibiotics are not in this category.
One of the best things you can do is to support your immune system and strengthen it. The NHS advice includes trying to eat well, hydrate properly, take regular exercise and get enough rest and sleep.
Hydroxychloroquine or chloroquine, sometimes in combination with an antibiotic called azithromycin, has been widely discussed and used recently for treatment of COVID-19. It is used and licensed for malaria and autoimmune diseases such as lupus. Currently, the safety and benefit of these medicines has not been proven in patients with COVID-19.
Hydroxychloroquine was being tested as part of a large global study coordinated by the World Health Organization. The study looked at a number of different drugs and their effect in COVID-19 patients. The hydroxychloroquine element of the study was put ‘on hold’ in May 2020. The Lancet medical journal published a study of coronavirus patients in 671 hospitals across six continents. It found those who took this drug were more likely to die or develop irregular heart rhythms than those who didn’t.
The RECOVERY trial in the UK has also now closed testing for use in COVID-19 stating that “preliminary results from the RECOVERY trial are quite clear – hydroxychloroquine does not reduce the risk of death among hospitalised patients with this new disease”.
On 29 June 2020, the MHRA approved recruitment of further participants for a clinical trial investigating hydroxychloroquine in the prevention of COVID-19, by the University of Oxford.
Update: On 17 June 2020, WHO announced that the hydroxychloroquine (HCQ) arm of the Solidarity Trial to find an effective COVID-19 treatment was being stopped.
Antibiotics do not treat viruses such as COVID-19, but they are absolutely essential for treating bacterial infections. Patients with COVID-19 are very susceptible to secondary bacterial infections which can only be treated with antibiotics. People on ventilators are particularly susceptible. We understand just how difficult it can be to find information on the internet which is trustworthy and reliable.
You can find help HERE to work out what sources of information you can trust during these difficult times of information overload.
There are a number of existing antiviral drugs under investigation through clinical trials for use against COVID-19. Most of these drugs are already used for other viral conditions such as Ebola or HIV and some strains of seasonal flu, and none are yet clinically proven against COVID-19.
Remdesivir is an antiviral drug under investigation against COVID-19. It has now been approved for clinical use in the UK for specific hospitalised patients.
It is important to note that an opportunistic or secondary bacterial infection can develop in patients with COVID-19. This means we also need governments, globally, to ensure we are also focussing on developing new antibiotic treatments to reduce poor outcomes from the secondary bacterial infections and not just antiviral drugs for COVID-19 itself.
Vitamin D helps to keep bones, teeth and muscles healthy. It also plays an important role in the immune system, which helps our body fight infection. However, the role that vitamin D plays in the management of COVID-19 is not completely clear currently.
Clinical studies are ongoing to determine if vitamin D helps prevent respiratory complications, or whether it provides specific protection towards Coronavirus. The emerging evidence suggests that the outcomes for those who develop COVID-19, and who already have a deficiency or insufficient levels of vitamin D, may be negatively affected in terms of morbidity (degree of ill health) and mortality (death rates).
The NHS across the UK advises anyone staying at home for most of the day, with limited exposure to sunlight, to consider taking a daily 10 microgram vitamin D supplement.
Links to further advice below:
The WHO guidance has not changed on the use of face masks to prevent the spread of COVID-19. The advice on this currently comes from the UK government.
Currently there is limited evidence for the use of masks (medical or other) for healthy individuals in the wider community. The WHO is actively studying the rapidly evolving science on masks and continuously updates its guidance. However, they stress that masks are not a replacement for good hand hygiene and social distancing practices.
In June 2020, WHO issued new guidance to recommend that all people wear three layer face coverings in enclosed spaces such as public transport and shops where social distancing is not possible to attempt to reduce transmission of COVID-19. They also recommend that people over 60 or with underlying health conditions should wear medical grade face masks where physical distancing is difficult to give themselves better protection and prevent the spread of COVID-19.
The governments within devolved countries are also issuing additional guidance and requirements on face coverings and masks which you can find on NHS information sites e.g. www.gov.uk.
If you have tested positive for coronavirus (COVID-19), you will probably have developed some immunity to the disease. But it cannot be guaranteed that will happen in all cases, nor exactly for how long that will last. There has been one report of a possible re-infection reported.
If you have previously tested positive but develop symptoms again, you must self-isolate for at least 7 days from onset of symptoms and be tested. If you live in a household, all other household members must stay at home for 14 days.
There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection according to the WHO. However medical and scientific advisors to the government have suggested that based on the anti-body response to other viral infections including coronaviruses, it is unlikely that a person would be infected for a second time. However, the virus causing COVID-19 is so new that this needs to be further validated with evidence.
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