Antibiotic resistance is a real menace nowadays. Adverse effects of antibiotics are also coming up at the same time. Everyone needs to know the adverse effects and dosages of the common antibiotics so that proper antibiotic stewardship can become a reality.

Antibiotics are antibacterial compounds. The broad umbrella term is antimicrobials which covers antibacterial compounds, antiviral drugs, antiparasitic drugs and also antifungal drugs. All antibiotics can have some adverse or untoward effects like rashes, vomiting and diarrhoea. Some more adverse effects are demonstrated by specific antibiotics. Knowledge of these adverse effects are vital in order to institute an antibiotic policy by the hospital or healthcare facility. 

 The first naturally derived antibiotic was discovered accidentally in 1928 in St. Mary’s Hospital, London by Alexander Fleming from the fungus Penicillium notatum [1]. Florey, Chain and others took Penicillin to clinical use in 1941. Many other classes of antibiotics were also later discovered, like quinolones, fluoroquinolones and sulfonamides. However, soon some adverse effects of antibiotics came to light. Also resistance to several antibiotics came up. 

Many antibiotics can just cause a taste alteration like metallic taste in the mouth. It is common with nitroimidazoles like Metronidazole. Also, sometimes the side effects are so mild that it may resemble features due to the infection also, like nausea and vomiting [2]. However, sometimes the adverse effects are quite serious and even irreversible.  Several times the antibiotics given may also interact with several drugs or other antibiotics given simultaneously.

The common adverse effects and drug interactions of antibiotics are listed below [2,3,4,5,6]:

There are many reasons for these adverse effects, like their metabolism, chemical properties and pharmacodynamics. Other effects are also marked with some antibiotics, like irreversible staining of teeth enamel with Tetracycline. This happens because Tetracycline, being a strong chelator, binds well to the hydroxyapatite portions of the growing parts of bones and teeth [7].

Clinicians and also common people need to be aware of the mild and serious side effects of the common antibiotics. This was awareness can be generated among the general public about the adverse effects of the commonly used antibiotics and antimicrobials in general. These things should also be part of the curricula of undergraduate and postgraduate students of medical and paramedical courses, so that sufficient knowledge about these adverse effects ate there among them.

The adverse effects of antibiotics need to be kept in mind while prescribing to patients. Pharmacists and other personnel also need to know these things in order to establish good antibiotic prescription norms and reduce the burden of adverse effects of antibiotics. The drug interactions of these antibiotics also need to be known so that those drugs should be avoided and not given concomitantly. Unnecessary use of antibiotics is particularly concerning because antibiotics may be associated with a number of such adverse drug events (also called ADEs) [8]. Scheduling of drugs and restricting their over the counter use may go a long way also in minimizing their adverse effects and drug interactions. This should lead us to an era where adverse effects of antibiotics are rare.