- J Lwanga, senior house officer in genitourinary medicine 1,
- A Mears, consultant in genitourinary medicine and HIV2,
- J S Bingham, consultant in genitourinary medicine1,
- C S Bradbeer, consultant in genitourinary medicine1
- 1Department of Genitourinary Medicine, Guy’s and St Thomas’ Hospital, London
- 2Department of Genitourinary Medicine, Imperial College Healthcare NHS Trust, London
- Correspondence to: C S Bradbeer
Genitourinary medicine clinics often prescribe antibiotics and, except for metronidazole, do not advise abstention from alcohol. However, patients often assume that they should avoid alcohol when taking any antibiotics. A Google search on “antibiotics and alcohol” finds many sites that advise abstention.
But this belief has no foundation, and no contraindication is given in the British National Formulary.1 We wondered how prevalent this myth was and whether patients ever skipped antibiotics to drink alcohol. A pilot survey showed that 76% of clinic staff believed the myth.
We asked a convenience sample of patients attending our clinic to complete a questionnaire on this subject. Ethics approval was obtained for the survey.
The patients returned 337 of the 410 (82.2%) questionnaires; 54% of respondents were women, 44% men (2% not stated). Mean age was 28.9 years. Almost a half (49.3%) said they were white, 24.6% said they were black, 12.5% said they were of mixed or Asian ethnicity, and 13.6% did not answer. Over a half (51.6%) had been educated to university level or beyond. Most (71.8%) believed that drinking alcohol while taking antibiotics would make them ill (table)⇓. Furthermore, 81% believed that alcohol might stop the antibiotic working properly.
Younger respondents were more likely to believe that drinking alcohol would make them ill (P=0.0013). Over three quarters of respondents said they didn’t drink alcohol if taking antibiotics. Only six (2.8%) admitted to having skipped a dose to have a drink. We found no correlation between level of education and beliefs held.
Although this study was conducted in a genitourinary medicine clinic, the questions related to antibiotic use in general, and the results show that belief in the myth is widespread. Fortunately, it seldom led to non-adherence to treatment—the myth was usually ignored or led to abstention from alcohol while taking antibiotics.
Prohibition of alcohol use in people being treated for a sexually transmitted disease is a recognised historical fact and may have punitive origins.2 However, one of us (JSB) heard the following explanation for the myth from the late Brigadier Sir Ian Fraser.3 In the second world war, penicillin was being trialled for infected gunshot and shrapnel wounds. Because it was in short supply, it had to be recovered from the urine of recipients for reuse later. Many soldiers convalescing in field hospitals were allowed beer as a comfort. This increased the volume of urine and made the process of recovering penicillin lengthier, so the commanding officer banned these troops from drinking beer, and this led to the belief that alcohol should not be consumed with antibiotics. We would be interested to hear evidence to corroborate or refute this explanation.
Cite this as: BMJ 2008;337:a2885