A recent study of antibiotics by the Centers for Disease Control and Prevention revealed that adverse reactions to antibiotics account for nearly 20% of all drug-related emergency room visits each year... occurring at a rate that puts them in a risk category just below blood thinners and seizure medications. The antibiotics responsible for the greatest number of emergency room visits were penicillins (e.g., Amoxicillin), clindamycin, sulfonamides (e.g., sulfamethoxazole-trimethoprim) and fluoroquinolones (e.g., Levofloxacin, Ciprofloxacin).

The most common reaction to an antibiotic is a skin rash -- most commonly hives, but it could also be a rosy rash, bumpy or flat, itchy or not, that can appear just about anywhere on the body. Such a rash may seem minor but should not be ignored. It's a sign that you aren't reacting well to the drug you've been taking. This doesn't necessarily warrant a visit to the emergency room, but it is a signal to ask your doctor whether you need to switch to a different drug or can safely continue taking the antibiotic.

Ignoring the rash may put you at risk for more severe problems since skin reactions may be a part of a more severe reaction, which can cause swelling of the face or tongue, wheezing or difficulty breathing, and lightheadedness or dizziness. Continuing to take the antibiotics can accelerate or worsen symptoms.

REDUCING THE RISK

According to Daniel Budnitz, MD, MPH, one of the study authors, many of these emergencies may be avoidable, as they are caused by inappropriate use of antibiotics, which are over-prescribed, putting tens of millions of people at risk each year. In fact, more than half of the 100 million antibiotic prescriptions doctors write for upper respiratory infections each year are unnecessary. Why? Half of these infections are viral and aren't helped by antibiotics, but some patients want them anyway, Dr. Budnitz said. "It's a perception problem -- people may not feel they get their money's worth if they don't come out of the doctor's office with a prescription."

Antibiotics are not like chicken soup -- they're not harmless, says Dr. Budnitz. He urges everyone to remember that there is a risk-benefit equation that should be considered regarding antibiotics, noting that there is a one in 1,000 risk that an antibiotic will send you to the emergency room. And, between 5% and 25% of people taking antibiotics suffer from diarrhea and/or cramps. The likelihood that you'll be among the unlucky ones depends in part on the strength and type of the drug and also the sensitivity of your gastrointestinal system.

With hospital-borne infections escalating, medical costs on the rise and emergency room over-crowding a bigger and bigger problem, it seems prudent to be certain that the antibiotic that you take is truly necessary. "No drug is without a risk of harm,” says Dr. Budnitz, “and unnecessary antibiotics are higher on the harm list."