Prophylactic antibiotics are antibiotics that you take to prevent infection. Normally, you take antibiotics when you have an infection. Your doctor may give you antibiotics ahead of time to prevent infection in some situations where your risk of infection is high.
Why Are Prophylactic Antibiotics Prescribed?
Prophylactic antibiotics are given for many different reasons. Here are the most common.
Dental procedures. Bacteria from your mouth can enter your bloodstream during some dental procedures. This is not normally a problem for people with healthy immune systems. They can easily fight off many infections. People with certain conditions are more likely to develop infections. Some of these include:
- Artificial heart valve
- Heart valve repaired with prosthetic material
- A heart transplant with a valve problem
- Congenital heart problems
- History of infective carditis, which is a type of serious heart infection
Surgeries. Some types of surgery have a high risk of infection. Your doctor will probably give you prophylactic antibiotics if you're having one of these types of surgeries. Some of these surgeries include:
- Head or neck cancer surgery
- Neurosurgery, which is surgery on your brain or spine
- Surgeries to place a device inside of you, such as a shunt or pacemaker
- Hysterectomy, which is the removal of your uterus
- Some orthopedic surgeries, such as hip or knee replacement
- Heart surgery
- Organ transplants
Labor and delivery. There are some circumstances when you might need prophylactic antibiotics during labor and delivery. Some of these circumstances may include:
- If you're having a C-section.
- If your membranes rupture prematurely.
- If you test positive for a type of bacteria called Group B streptococcus (GBS).
- If you have heart disease that has a high risk for infection.
- If your placenta has to be removed manually.
Chronic infections. Your doctor may give you antibiotics to prevent infections if you have recurrent chronic infections. The most common of these are urinary tract infections (UTI), recurrent skin infections, and frequent flare-ups of chronic obstructive pulmonary disease (COPD).
Weakened immune system. You may need prophylactic antibiotics before a procedure if you have a weakened immune system. Some reasons you might have a weak immune system can include:
- HIV
- Neutropenia, which is when you have fewer of a certain type of white blood cells than normal
- Chemotherapy
- Lupus or another autoimmune disease such as juvenile arthritis
- Uncontrolled diabetes
- Chronic use of high-dose steroids
- Sickle-cell anemia
- Splenectomy, which is when you've had your spleen removed
- Severe combined immunodeficiency, which is a rare genetic disease
- Head and neck radiation
What Are the Benefits of Prophylactic Antibiotics?
Prophylactic antibiotics decrease your risk of developing infections that can sometimes be life-threatening. Prophylactic antibiotics can also stop a chronic or recurrent infection from coming back.
What Are the Risks of Prophylactic Antibiotics?
Antibiotic resistance. The biggest concern with prophylactic antibiotics is antibiotic resistance. This is a problem that affects everyone, not just people taking prophylactic antibiotics. Antibiotic resistance happens when germs such as bacteria and fungi learn to defeat the antibiotics that previously killed them. They become very difficult to treat when this happens.
Research has shown that antibiotic resistance often happens through the following process:
- There are a lot of germs, but only a few are resistant to antibiotics.
- Antibiotics kill not only the germs causing your disease but also the beneficial bacteria that protect your body.
- The antibiotic-resistant bacteria spread and take over.
- The antibiotic-resistant bacteria then pass along their resistance to other bacteria.
Many modern medical treatments depend on antibiotics to be effective. These treatments include:
- Sepsis treatment
- Surgery
- Chronic disease
- Organ transplant
- Dialysis for kidney disease
- Chemotherapy
Side effects. Like all medicines, antibiotics can have side effects. Some side effects from antibiotics can include:
- Nausea
- Diarrhea
- Rash
- Yeast infections
- Allergic reactions
- Clostridium difficile (C. diff) infection, which is difficult to treat and causes severe and possibly life-threatening diarrhea