Foods to Eat and Foods to Avoid

When you begin to feel the pain of a urinary tract infection or strep throat, you may be prescribed a course of antibiotics in order to recover. Antibiotics may be needed for many types of bacterial infections, but what you eat while taking this medication may affect how well it works and how well you get.

Why is it important what you eat?

Some foods can interact with an antibiotic by reducing its absorption by the body or even blocking the drug, while other foods can intensify side effects like gastrointestinal upset.

Antibiotics are a double-edged sword. Although these drugs can eliminate your infection, they can also affect the natural balance of bacteria in your system. This can lead to nausea, gas, and diarrhea in many people taking antibiotics.

If you’re unfamiliar with a new medication, it’s always a good idea to ask your pharmacist who has experience managing food-drug interactions for guidance.

Lia Robichaud and Alicia Li, pharmacy interns at Samaritan Albany General Hospital, described some common foods that can impact antibiotics.

Foods can interfere with antibiotics

Dairy Products and Calcium-Rich Foods – Whether it’s cheese, milk, coffee creamer, yogurt or butter, the calcium in dairy products could be a problem. Tofu, kale and chia seeds are also high in calcium. When you eat these foods with certain antibiotics like tetracyclines or fluoroquinolones, the medicine can bind to calcium, preventing it from being absorbed by your body. Space these foods at least two hours after taking your antibiotic and six hours before your next dose.

Fortified foods – Fortified foods can contain a high amount of calcium, creating the same problem as foods that are naturally high in calcium – possibly interfering with your antibiotics. Common fortified foods include breakfast cereals, orange juice, and non-dairy milk. Space these foods at least two hours after taking your antibiotic and six hours before your next dose.

Highly Acidic Foods – Citrus fruits and juices like orange and grapefruit, sodas, chocolate, and tomato products have a high acid content, which could reduce the amount of medicine absorbed by your system for some antibiotics. Space these foods at least two hours after taking your antibiotic and six hours before your next dose. Caffeine – Some antibiotics can increase the effects of caffeine – and not in a good way. Antibiotics can stop your body from metabolizing caffeine so that it stays in your system longer. A morning cup of coffee could lead to an increase in the diuretic effects of caffeine, jitters throughout the day, and a sleepless night. Stick to caffeine-free beverages while taking antibiotics, including plenty of water to stay hydrated.

Alcohol – Put cocktails or a glass of wine with dinner on hold. It is best to completely abstain from alcohol until 48 hours after you have finished your antibiotic treatment if you are taking metronidazole. Be on the lookout for alcohol or propylene glycol in mouthwashes, cough medicine, or cold and flu products, and avoid them as well. Drinking alcohol while taking certain antibiotics can cause severe nausea and vomiting, headaches, and other side effects.

Multi-vitamins and antacids – These products may contain minerals – mainly magnesium, calcium, aluminium, iron or zinc – which bind to the antibiotic and prevent it from working. You can take multivitamins and antacids as long as you space them out at least two hours after taking your antibiotic and six hours before your next dose.

What to eat instead

Soup – Enjoy broth-based soups that don’t rely on cream, cheese, or tomatoes for flavor like chicken noodles, ramen, miso, or lentils. These soups often contain beneficial prebiotic foods like garlic, onion, vegetables, and beans that help regrow healthy bacteria.

bland foods – In general, foods to eat when sick are also appropriate when taking antibiotics. Plain or lightly salted crackers, peanut butter, and non-citrus fruits are good choices. The BRAT diet (bananas, rice, applesauce, toast) can help with diarrhea due to antibiotics.

Water – It is important to stay hydrated, especially when you are sick. It helps your body fight infection, your medications to work properly, and fight some of the gastrointestinal side effects of antibiotics.

fermented foods – Sauerkraut, kimchi, miso, fermented vegetables, and kombucha contain beneficial probiotics that can support your gut and can help offset some of the unpleasant side effects of antibiotics. Yogurt and kefir can also be helpful, especially the Nancy brand. Make sure dairy products are spaced far enough away from your antibiotic.

Probiotic supplements – Taking probiotics while taking antibiotics can help supply beneficial bacteria to your system and can also help with diarrhea. Some common brands include Culturelle, RenewLife and Florastor. If your provider prescribes probiotics with your antibiotic, they can be taken at the same time and do not need to be spaced out. Otherwise, follow the instructions on the label. Your provider may recommend that you take a probiotic supplement for up to a week after your antibiotic treatment is finished.

Take antibiotics correctly

• Always follow the directions on the medicine label. Always finish your diet, even if you start to feel better. Don’t save the antibiotics for another time.
• Some antibiotics shouldn’t be broken, crushed, or chewed, so check the label. If you have trouble swallowing pills, talk to your provider who can discuss other options with you.
• If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose, around three to four hours away. Doses are timed to keep a constant amount of medicine in your body. Taking the doses too close together or taking a double dose may increase your side effects and have no benefit.
• If you miss all your doses in a 24 hour period, call your provider.
• If the label says to take with food, you can take your medicine with a meal or a small snack such as crackers and fruit. Food helps the body absorb certain medications and may reduce side effects.
• If the label says to take on an empty stomach, plan your meals either one hour after taking the medicine or two hours before your next dose. Some medications work better if there is no other food in the stomach.

Once you’re done with antibiotics, help healthy bacteria grow

According to a study of gut bacteria published in the journal Clinical Infectious Diseases, the gut microbiota mostly repopulates within two to four weeks of stopping antibiotic treatment. However, it can take up to a year or more for your gut microbiota to fully recover.

Other bacterial colonies on your body can also be affected by antibiotics. For example, women can sometimes develop a yeast infection after a round of broad-spectrum antibiotics because the antibiotics kill off beneficial bacteria in the vagina.

You can encourage a diverse population of beneficial bacteria to regrow and stay healthy by making prebiotic and probiotic foods a priority. It’s also helpful to limit sugar and processed foods for several weeks, as they can suppress healthy bacterial growth.

Antibiotics are sometimes necessary, but the medical community is still learning all of the long term effects on the body. Take your medicine as prescribed and talk to your pharmacist if you have any questions about the proper way to take antibiotics.

Work with a pharmacy you trust. Find a Samaritan Pharmacy near you.