question: how does drinking alcohol decreases the effectiveness of antibiotics?
comment: Most antibiotics do not contraindicate with alcohol however alcohol makes it more likely for you to vomit.. so it’s just cautionary advice... to ensure you complete the proper course for your Ailment.
passages: Section::::Interactions.:Alcohol.
  
  Interactions between alcohol and certain antibiotics may occur and may cause side effects and decreased effectiveness of antibiotic therapy. While moderate alcohol consumption is unlikely to interfere with many common antibiotics, there are specific types of antibiotics, with which alcohol consumption may cause serious side effects. Therefore, potential risks of side effects and effectiveness depend on the type of antibiotic administered.
   Antibiotics such as metronidazole, tinidazole, cephamandole, latamoxef, cefoperazone, cefmenoxime, and furazolidone, cause a disulfiram-like chemical reaction with alcohol by inhibiting its breakdown by acetaldehyde dehydrogenase, which may result in vomiting, nausea, and shortness of breath. In addition, the efficacy of doxycycline and erythromycin succinate may be reduced by alcohol consumption. Other effects of alcohol on antibiotic activity include altered activity of the liver enzymes that break down the antibiotic compound.
  
  Section::::Pharmacodynamics.
   Macrolide antibiotics (e.g., clarithromycin) may be used in patients with a history of allergy to beta-lactam antibiotics. Macrolide resistance has also been observed.
  
  Section::::Serious complications.
  
  The serious complications of HiB are brain damage, hearing loss, and even death.
  
  Section::::Prevention.
   The treatment for auto-brewery syndrome is a change in diet requiring low carbohydrates and high protein. Sugar is fermented into alcohol, and a diet that effectively lowers sugars also lowers the alcohol that can be fermented from it. Anything that causes an imbalance between the beneficial and harmful bacteria in the gut can help increase the chance that fermentation in the gut will develop. This can include not only antibiotics, but also overindulgence in sugars and carbohydrates. Watching what you eat could lower the risk of gut fermentation syndrome, and taking probiotics could further protect you by increasing the number of good bacteria in your system.
   BULLET::::- 1972 – minocycline
  
  BULLET::::- 1972 – pristinamycin
  
  BULLET::::- 1973 – fosfomycin
  
  BULLET::::- 1974 – talampicillin
  
  BULLET::::- 1975 – tobramycin
  
  BULLET::::- 1975 – bacampicillin
  
  BULLET::::- 1975 – ticarcillin
  
  BULLET::::- 1976 – amikacin
  
  BULLET::::- 1977 – azlocillin
  
  BULLET::::- 1977 – cefadroxil
  
  BULLET::::- 1977 – cefamandole
  
  BULLET::::- 1977 – cefoxitin
  
  BULLET::::- 1977 – cefuroxime
  
  BULLET::::- 1977 – mezlocillin
  
  BULLET::::- 1977 – pivmecillinam
  
  Section::::From 1978.
  
  BULLET::::- 1979 – cefaclor
  
  BULLET::::- 1980 – cefmetazole
  
  BULLET::::- 1980 – cefotaxime
  
  BULLET::::- 1980 – piperacillin
  
  BULLET::::- 1981 – co-amoxiclav (amoxicillin/clavulanic acid)
  
  BULLET::::- 1981 – cefoperazone
  
  BULLET::::- 1981 – cefotiam
  
  BULLET::::- 1981 – cefsulodin
  
  BULLET::::- 1981 – latamoxef
   BULLET::::- 1961 – ampicillin
  
  BULLET::::- 1961 – spectinomycin
  
  BULLET::::- 1961 – sulfamethoxazole
  
  BULLET::::- 1961 – trimethoprim, the first dihydrofolate reductase inhibitor
  
  BULLET::::- 1962 – cloxacillin
  
  BULLET::::- 1962 – fusidic acid
  
  BULLET::::- 1963 – fusafungine
  
  BULLET::::- 1963 – lymecycline
  
  BULLET::::- 1964 – gentamicin
  
  BULLET::::- 1964 – cefalotin, the first cephalosporin
  
  BULLET::::- 1966 – doxycycline
  
  BULLET::::- 1967 – carbenicillin
  
  BULLET::::- 1967 – rifampicin
  
  BULLET::::- 1967 – nalidixic acid, the first quinolone
  
  BULLET::::- 1968 – clindamycin, the second lincosamide
  
  BULLET::::- 1970 – cefalexin
  
  BULLET::::- 1971 – cefazolin
  
  BULLET::::- 1971 – pivampicillin
  
  BULLET::::- 1971 – tinidazole
  
  BULLET::::- 1972 – amoxicillin
  
  BULLET::::- 1972 – cefradine
   Section::::Research.:Antibiotics: Biosynthesis and Resistance Mechanisms.
   BULLET::::- 1981 – netilmicin
  
  BULLET::::- 1982 – ceftriaxone
  
  BULLET::::- 1982 – micronomicin
  
  BULLET::::- 1983 – cefmenoxime
  
  BULLET::::- 1983 – ceftazidime
  
  BULLET::::- 1983 – ceftizoxime
  
  BULLET::::- 1983 – norfloxacin
  
  BULLET::::- 1984 – cefonicid
  
  BULLET::::- 1984 – cefotetan
  
  BULLET::::- 1984 – temocillin
  
  BULLET::::- 1985 – cefpiramide
  
  BULLET::::- 1985 – imipenem/cilastatin, the first carbapenem
  
  BULLET::::- 1985 – ofloxacin
  
  BULLET::::- 1986 – mupirocin
  
  BULLET::::- 1986 – aztreonam
  
  BULLET::::- 1986 – cefoperazone/sulbactam
  
  BULLET::::- 1986 – co-ticarclav (ticarcillin/clavulanic acid)
  
  BULLET::::- 1987 – ampicillin/sulbactam
  
  BULLET::::- 1987 – cefixime
  
  BULLET::::- 1987 – roxithromycin
  
  BULLET::::- 1987 – sultamicillin
  
  BULLET::::- 1987 – ciprofloxacin, the first 2nd-gen fluoroquinolone
   A study published in 2018 showed multi drug-resistant "E. faecium" exhibiting tolerance to alcohol-based solutions. The authors speculated about this being an explanation to an increase of "E. faecium" infections, indicating that alternate methods are required to slow the spread of "E. faecium" in a hospital setting. The study found that isolates of the bacterium from after 2010 were 10 times more tolerant of the alcohol-based disinfectants than older isolates. However, the isopropanol solutions tested in this study used isopropanol concentrations lower than those used in most hand desinfectants and the authors also stated that hand disinfectants using 70 % isopropanol were effective in full strength even against tolerant strains . However, a mouse gut colonization model of "E. faecium" transmission showed that alcohol-tolerant "E. faecium" resisted standard 70% isopropanol surface disinfection, resulting in greater mouse gut colonization compared to alcohol-sensitive "E. faecium." This research has led some to question whether it may be possible for microbes to become entirely tolerant of alcohol. 
   Tetracycline has been used with some success in the treatment of localised juvenile periodontitis and this has proven to be particularly effective with in vitro studies of organisms associated with chronic and juvenile periodontitis.
   Section::::Pharmacology.:Mechanism of action.
  
  Bacteria constantly remodel their peptidoglycan cell walls, simultaneously building and breaking down portions of the cell wall as they grow and divide. "β"-Lactam antibiotics inhibit the formation of peptidoglycan cross-links in the bacterial cell wall; this is achieved through binding of the four-membered "β"-lactam ring of penicillin to the enzyme DD-transpeptidase. As a consequence, DD-transpeptidase cannot catalyze formation of these cross-links, and an imbalance between cell wall production and degradation develops, causing the cell to rapidly die.
   Antibiotic use in dentistry
  
  There are many circumstances during dental treatment where antibiotics are prescribed by dentists to prevent further infection (e.g. post-operative infection). The most common antibiotic prescribed by dental practitioners is penicillin in the form of amoxicillin, however many patients are hypersensitive to this particular antibiotic. Therefore, in the cases of allergies, erythromycin is used instead.
  
  Section::::Post-operative Infections.
  
  Section::::Post-operative Infections.:Bacteraemia.
   Penicillin is a bactericidal antibiotic that works by inhibiting cell wall synthesis but this synthesis only occurs when bacteria are actively replicating (or in the log phase of growth). In cases of extremely high bacterial burden (such as with Group A Strep), bacteria may be in the stationary phase of growth. In this instance since no bacteria are actively replicating (presumably due to nutrient restriction) penicillin has no activity. This is why adding an antibiotic like clindamycin, which acts ribosomally, kills some of the bacteria and returns them to the log phase of growth .
   BULLET::::- 1987 – rifaximin, the first ansamycin
  
  BULLET::::- 1988 – azithromycin
  
  BULLET::::- 1988 – flomoxef
  
  BULLET::::- 1988 – isepamycin
  
  BULLET::::- 1988 – midecamycin
  
  BULLET::::- 1988 – rifapentine
  
  BULLET::::- 1988 – teicoplanin
  
  BULLET::::- 1989 – cefpodoxime
  
  BULLET::::- 1989 – enrofloxacin
  
  BULLET::::- 1989 – lomefloxacin
  
  BULLET::::- 1989 – moxifloxacin
  
  BULLET::::- 1990 – arbekacin
  
  BULLET::::- 1990 – cefodizime
  
  BULLET::::- 1990 – clarithromycin
  
  BULLET::::- 1991 – cefdinir
  
  BULLET::::- 1992 – cefetamet
  
  BULLET::::- 1992 – cefpirome
  
  BULLET::::- 1992 – cefprozil
  
  BULLET::::- 1992 – ceftibuten
  
  BULLET::::- 1992 – fleroxacin
  
  BULLET::::- 1992 – loracarbef
  
  BULLET::::- 1992 – piperacillin/tazobactam
  
  BULLET::::- 1992 – rufloxacin
  
  BULLET::::- 1993 – brodimoprim
   The first major development was ampicillin in 1961. It offered a broader spectrum of activity than either of the original penicillins. Further development yielded β-lactamase-resistant penicillins, including flucloxacillin, dicloxacillin, and methicillin. These were significant for their activity against β-lactamase-producing bacterial species, but were ineffective against the methicillin-resistant "Staphylococcus aureus" (MRSA) strains that subsequently emerged.
   Administration of antibiotics as soon as possible is necessary to reduce the risk of infection. However, antibiotics may not provide necessary benefits in open finger fractures and low velocity firearms injury. First generation cephalosporin (cefazolin) is recommended as first line antibiotics for the treatment of open fractures. The antibiotic is useful against gram positive cocci and gram negative rods such as "Escherichia coli", "Proteus mirabilis", and "Klebsiella pneumonia". To extend the coverage of antibiotics against more bacteria in Type III Gustilo fractures, combination of first generation cephalosporin and aminoglycoside (gentamicin or tobramycin) or a third generation cephalosporin is recommended to cover against nosocomial gram negative bacilli such as "Pseudomonas aeruginosa". Adding penicillin to cover for gas gangrene caused by anaerobic bacteria "Clostridium perfringens" is a controversial practice. Studies has shown that such practice may not be necessary as the standard antibiotic regimen is enough to cover for Clostridial infections. Antibiotic impregnated devices such as tobramycin impregnated Poly(methyl methacrylate) (PMMA) beads and antibiotic bone cement are helpful in reducing rates of infection. The use of absorbable carriers with implant coatings at the time of surgical fixation is also an effective means of delivering local antibiotics.
   Like other β-lactam antibiotics, renal excretion of cefalexin is delayed by probenecid. Alcohol consumption reduces the rate at which it is absorbed. Cefalexin also interacts with metformin, an antidiabetic drug, and this can lead to higher concentrations of metformin in the body. Histamine H receptor antagonists like cimetidine and ranitidine may reduce the efficacy of cefalexin by delaying its absorption and altering its antimicrobial pharmacodynamics.
  
  Section::::Pharmacology.
  
  Section::::Pharmacology.:Mechanism of action.
   Treatment of AIT involves antibiotic treatment. Based on the offending organism found on microscopic examination of the stained fine needle aspirate, the appropriate antibiotic treatment is determined. In the case of a severe infection, systemic antibiotics are necessary. Empirical broad spectrum antimicrobial treatment provides preliminary coverage for a variety of bacteria, including "S. aureus" and "S. pyogenes." Antimicrobial options include penicillinase-resistant penicillins (ex: cloxacillin, dicloxacillin) or a combination of a penicillin and a beta-lactamase inhibitor. However, in patients with a penicillin allergy, clindamycin or a macrolide can be prescribed. The majority of anaerobic organisms involved with AIT are susceptible to penicillin. Certain Gram-negative bacilli (ex: "Prevotella", "Fusobacteria", and "Porphyromonas") are exhibiting an increased resistance based on the production of beta-lactamase. Patients who have undergone recent penicillin therapy have demonstrated an increase in beta-lactamase-producing (anaerobic and aerobic) bacteria. Clindamycin, or a combination of metronidazole and a macrolide, or a penicillin combined with a beta-lactamase inhibitor is recommended in these cases. Fungal thyroiditis can be treated with amphotericin B and fluconazole. Early treatment of AIT prevents further complications. However, if antibiotic treatment does not manage the infection, surgical drainage is required. Symptoms or indications requiring drainage include continued fever, high white blood cell count, and continuing signs of localized inflammation. The draining procedure is also based on clinical examination or ultrasound/CT scan results that indicate an abscess or gas formation. Another treatment of AIT involves surgically removing the fistula. This treatment is often the option recommended for children. However, in cases of an antibiotic resistant infection or necrotic tissue, a lobectomy is recommended. If diagnosis and/or treatment is delayed, the disease could prove fatal.
   Erythromycin: This is a wide spectrum antibiotic that has a similar range on the antibacterial spectrum to penicillin, making it the ideal first choice if patients are allergic to penicillin. It is also useful for treatment against B-lactamase-producing bacteria although it is not particularly as effective against oral and dental infections, due to such infections usually being caused by obligate anaerobes.
   Aerosolization of antibiotics is necessary because infections of the lung are especially troublesome, which is why direct targeting of the infection is needed. Broad spectrum antibiotics can have detrimental side effects when their action is also taken against necessary non-pathogenic bacteria residing in the human microbiome. Aerosolization is effective in bypassing the microbiome that exists in the gastrointestinal tract by directing the antibiotic directly to the lungs. This process is undertaken after the production of the antibiotic itself.
   Some bacteria produce enzymes that break down the beta-lactam ring, called beta-lactamases, which make the bacteria resistant to penicillin. Therefore, some penicillins are modified or given with other drugs for use against antibiotic resistant bacteria or in immunocompromised patients. Use of clavulanic acid or tazobactam, beta-lactamase inhibitors, alongside penicillin gives penicillin activity against beta-lactamase producing bacteria. Beta lactamase inhibitors irreversibly bind to beta-lactamase preventing it breaking down on beta lactam rings on the antibiotic molecule. Alternatively, flucloxacillin is a modified penicillin that has activity against beta-lactamase producing bacteria due to an acyl side chain that protects the beta lactam ring form beta lactamase.
   Azithromycin has been used to treat strep throat (Group A streptococcal (GAS) infection caused by "Streptococcus pyogenes") in penicillin-sensitive patients, however macrolide-resistant strains of GAS are not uncommon. Cephalosporin is another option for these patients.
  
  Section::::Side-effects.
   BULLET::::2. binding to the ribosome and distorting the structure to still allow t-RNA binding while tetracycline is bound
  
  BULLET::::3. binding to the ribosome and dislodging tetracycline
  
  Section::::Administration.
   There is a common side effect that can develop when other medications are used. This is the development of cross sensitivities to other antibiotics. If someone has developed side effects when taking penicillin, these side effects may develop with a new medication even though the person has not taken the new medication before. Those medications that may cause a cross sensitivity reaction are: carbapenems, ampicillin, cefazolin, cephalosporins and cloxacillin.
  
  Section::::Side effects in adults.
   Amoxicillin/clavulanic acid is widely used to treat or prevent many infections caused by susceptible bacteria, such as:
  
  BULLET::::- urinary tract infections
  
  BULLET::::- respiratory tract infections
  
  BULLET::::- skin and soft tissue infections
  
  BULLET::::- sinus infections
  
  BULLET::::- cat scratches
  
  BULLET::::- infections caused by the bacterial flora of the mouth, such as:
  
  BULLET::::- dental infections
  
  BULLET::::- infected animal bites
  
  BULLET::::- infected human bites (including uncomplicated "clenched-fist" or "reverse-bite" injuries)
  
  This combination results in an antibiotic with an increased spectrum of action and restored efficacy against amoxicillin-resistant bacteria that produce β-lactamase.
  
  Section::::Adverse effects.
  
presuppositions: Alcohol stops antibiotics from working. Drinking alcohol decreases the effectiveness of antibiotics.
corrections: Alcohol doesn't stop them from working it just makes you likely to puke them up which would be a waste of them.  Alcohol makes it more likely you will vomit out the antibiotics and not be able to complete the proper course.
raw_presuppositions: Alcohol stops antibiotics from working. Drinking alcohol decreases the effectiveness of antibiotics.
raw_corrections: Alcohol doesn't stop them from working it just makes you likely to puke them up which would be a waste of them.  Alcohol makes it more likely you will vomit out the antibiotics and not be able to complete the proper course.