Women are significantly more likely to receive antibiotics than men, experience a higher rate of adverse reactions, and remain underrepresented in clinical trials evaluating these medications, according to a newly published review. The findings, reported by Medscape News Europe, are prompting calls for clinicians to adopt a “sex-aware” approach to antibiotic prescribing.
The review highlights a disparity in antibiotic use, with women receiving 25% to 40% more prescriptions compared to men. Simultaneously, women report up to twice as many adverse reactions to antibiotics, raising concerns about potential sex-based differences in drug metabolism, microbiome composition, and immune responses.
While antibiotics are designed to combat bacterial infections – such as strep throat and urinary tract infections – they are ineffective against viral illnesses like the common cold, a point emphasized by Brad Spellberg, MD, Chief Medical Officer at the Los Angeles General Medical Center. Despite this, patients often request antibiotics for conditions where they offer no benefit.
Common side effects of antibiotics include digestive problems like nausea, indigestion, vomiting, diarrhea, and bloating, according to health sources. These symptoms typically resolve once the medication is stopped, but severe cases – such as bloody diarrhea or uncontrollable vomiting – require immediate medical attention. Antibiotics can too disrupt the body’s natural microbiome, leading to opportunistic fungal infections in the mouth, digestive tract, or vagina. Symptoms of these infections range from white patches in the mouth to vaginal itchiness and discharge.
The Centers for Disease Control and Prevention (CDC) reports that one in five medication-related emergency room visits are linked to antibiotic side effects. Severe reactions, including anaphylaxis – characterized by difficulty breathing, chest pain, or throat tightness – necessitate immediate emergency medical care, including calling 911.
Certain antibiotics, like tetracycline and doxycycline, can cause photosensitivity, resulting in skin irritation. The review underscores the need for increased research into sex-specific responses to antibiotics, as current clinical trials often lack sufficient female representation, hindering a comprehensive understanding of these differences.
The findings arrive as antibiotic resistance continues to be a growing global health threat. Shorter courses of antibiotics, when appropriate, are being advocated as a strategy to reduce both side effects and the development of resistance, according to recent reports.
