What Happens If You Take Expired Antibiotics
There’s no question that antibiotics have saved countless lives over the past century — but their widespread use has also led to an alarming rise in antibiotic resistant bacteria. According to Centers for Disease Control and Prevention (CDC), nearly 2 million people die each year from drug-resistant infections, while tens of thousands more suffer life-threatening conditions like bloodstream infections, pneumonia, and urinary tract infections. These superbugs cause so much harm because they’re immune to most medicines we have available today.
Antibiotic resistance is caused by several things, including improper prescribing practices, patients not finishing all prescribed doses, and even using ineffective antibiotics when you should be taking something else. But it’s important to note that bacterial growth itself doesn’t lead directly to antibiotic resistance; rather, the problem arises when bacteria continue to grow despite having taken a potent dose of medicine. This happens when doctors prescribe antibiotics incorrectly or patients don’t finish the entire prescription.
When this happens, some bacteria actually develop resistance to certain antibiotics. For example, say your doctor prescribes you penicillin G potassium to fight strep throat, but after three days of treatment you start feeling better, only to find out later that the infection was susceptible to another class of drugs called macrolides. The culprit here is likely the fact that the first antibiotic wasn’t working as well as it could’ve been. Bacteria that become resistant to one type of antibiotic won’t necessarily become resistant to others, but if they do, then these strains may spread to other types of bacteria that haven’t yet developed immunity. And once this occurs, bacteria will need to adapt again and again until there’s a whole new generation of antibiotics with which to combat them.
According to the CDC, “Drugs lose potency” — meaning they stop being fully effective against specific germs — “for many reasons,” such as expiration dates, manufacturing problems, contamination, poor storage, etc., and that includes antibiotics. Not all expiry dates on pharmaceutical products are created equal, however, since there isn’t any international standard regarding how long a particular medication must sit before becoming useless. In general, though, FDA regulations mandate that drugs expire within two years, and vaccines last anywhere from six months to a few years.
Even if a product does meet its expiration date, it might still contain lower amounts of active ingredients than it did when it was brand new. A 2013 study published in Clinical Infectious Diseases found that among various brands of generic cephalosporins (a common family of antibacterial drugs used to treat community-acquired pneumonia, UTIs, skin infections, and intraabdominal infections) tested, some were up to 40 percent weaker than they had originally contained. Similar results were seen in a separate 2012 study, where researchers discovered that fluoroquinolones (antimicrobial agents commonly used to treat severe bacterial infections and parasitic diseases) lost potency after sitting on store shelves for up to five years.
Why does this happen? There are several possibilities, but according to a 2016 article published in Journal of Hospital Pharmacy Practice, one reason is that during production, manufacturers rely on high temperatures to break down inactive ingredients into smaller molecules, which allows active ones to remain stable longer. Once the process stops, however, the remaining chemicals are left unprocessed, resulting in weakened products. Another factor is that bacteria are capable of consuming small amounts of antibiotics without killing themselves off, thus slowly making the drug less effective. So if you took an expired version of what you thought was a full course of antibiotics, you’d probably end up sicker than you would’ve otherwise.
It’s important to remember that bacteria aren’t always going to be able to consume every single bit of medicine inside of them, especially with regard to low-dose treatments, which tend to take longer to kill everything off. But in cases where larger quantities of medicine are involved, bacteria might just get around to absorbing enough to make the medicine less effective. This means that if you didn’t follow instructions properly, you could end up doing more damage than good.
So if you’re wondering whether it’s okay to take an expired medication, the answer is yes, as long as you’re sure about what you’re doing. The key thing to keep in mind is that expired medications aren’t necessarily worthless — they simply need to be handled carefully, and ideally given to someone who’s experienced with handling them. Otherwise, you run the risk of causing yourself more harm than good.
If you’re curious about why some antibiotics are stronger at different times, check out our explanation of antibiotic concentrations in action.
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