What should we do with leftover antibiotics?

There is a pack of antibiotics in your cupboard that was not fully used. A few days later a sore throat or a burning feeling when passing urine begins, and the first thought is to take that same medicine. It was prescribed by a doctor, so why not? This article explains what reliable sources say about that temptation.

Why shouldn’t we save medicine for later?

The CDC is clear: do not save antibiotics for later. The explanation is that medicine meant for a different illness can delay the right treatment and cause serious side effects.

The reason can be seen from the prescription. The doctor wrote that medicine for a specific infection at a specific time. The new symptom may be a different infection, and may not even be bacterial. The CDC and NHS both say antibiotics do not work on viruses, which means colds, flu and most coughs. MedlinePlus also says that taking an antibiotic when it is not needed does not make you better and may lead to drug resistance.

Do not take other people’s medicine either

The CDC says not to share your antibiotics with others. The NHS also says to take only an antibiotic prescribed for you and not to “borrow” one from friends or family. This holds both for medicine someone offers you and for medicine you offer your relatives.

What about side effects?

The CDC lists the common side effects as skin rash, dizziness, nausea, diarrhoea and yeast infections. There are more serious ones too, including severe allergy and diarrhoea from C. diff infection, which the CDC says can lead to severe damage to the large bowel. The NHS, on the other hand, reminds us that when antibiotics are used correctly most people have no problem and serious side effects are rare. So there is no need for needless worry.

If you get a side effect while taking an antibiotic, the CDC says to contact your doctor.

What do we do with a new symptom?

• Tell the doctor about the symptom. If a bacterium is the cause, the doctor will decide after an examination whether a culture is needed. MedlinePlus says that if the result shows you do not have a bacterial infection, you should not take an antibiotic. If you are taking a medicine now, ask your doctor whether to stop or continue it.
• Take the medicine box with you. The name and date on the medicine help the doctor see what you have taken before. The first-visit guide has the checklist.
• Do not press for medicine. The CDC stresses never pressuring your doctor to prescribe an antibiotic, and suggests asking what will make the symptoms better while your body fights the infection.
• If the symptoms are those of the same earlier infection coming back, see resistant and recurring infections. There are different reasons an infection returns, and a doctor needs to assess it.

If you are still in the middle of a course

The CDC says to take the medicine exactly as prescribed. If you have questions about the amount or timing, ask your doctor or pharmacist. Do not reduce, increase or stop it yourself; see also the guide on taking antibiotics the right way.

Where do we dispose of leftovers?

For any expired or unused medicine, the CDC gives two ways. One is drug take-back programmes, often found at local pharmacies. The other is mixing the medicine with soil, cat litter or used coffee grounds in a plastic bag and putting it in the rubbish. The CDC and MedlinePlus both recommend asking a pharmacist how to dispose of leftovers safely. A take-back programme may not exist in your city; asking the pharmacist is the simplest start.

Drug resistance

WHO counts misuse and overuse of antibiotics among the main drivers of drug resistance. The CDC reminds us that resistance belongs to the germ, not to your body, and a resistant germ can spread to others as well. For this reason the advice not to save or share medicine is not only about your own health.

A reminder

This article is for information only. The decision about starting, continuing or changing a medicine belongs to your doctor. If with a new symptom you notice confusion, fast breathing, pallor or a rash that does not fade under pressure, see the urgent signs and call 115, Iran’s emergency number.