Antibiotics and Diabetes: Everything You Need To Know

Antibiotics and Diabetes

Antibiotics are drugs used to kill bacteria. Individuals with diabetes are more at risk of getting infections as they have impaired immunity.

In addition, bacteria love glucose, and individuals with diabetes, especially those with uncontrolled diabetes, have high levels of glucose in their blood making them prone to infections.

Prevention via controlling blood glucose, maintaining good hygiene, and vaccinations is the key. However, once a person with diabetes gets an infection, they need to receive antibiotics promptly when they start experiencing symptoms.

It is best to choose the safest antibiotics because of the risk of kidney failure, hypoglycemia, hyperglycemia, and opportunistic fungal infections.

It is also important to choose the most effective antibiotics to prevent complications and get cured early.


What Are Antibiotics?

In its most basic sense, antibiotics help your body fight infections due to bacteria. Furthermore, antibiotics work by either stopping the bacteria from reproducing in your body or by eradicating the bacteria.

Additionally, several modern antibiotics help target a specific infection: cephalosporins, macrolides, tetracyclines, fluoroquinolones, sulfonamides, and aminoglycosides.

Cephalosporins are used to treat skin and respiratory infections, whereas macrolides are used to treat chest and lung infections.

Tetracyclines are used for rosacea and acne, fluoroquinolones are antibiotics for your urinary tract, sulfonamides are for eye and ear infections, and aminoglycosides are for severe infections like sepsis.

Since there are different options, prices for the same antibiotics also come in different ranges. By comparison, Amoxicot or other branded forms of amoxicillin can cost more, whereas a generic, common amoxicillin tablet price: is $0.43.

Nonetheless, you don’t have to buy the costly ones as every pill is targeted for a specific infection, so you only need to get the one you need.

Of course, this only applies to generic and branded name medications. You can’t substitute an antibiotic with another antibiotic, so do follow prescriptions by your doctor.


Antibiotics and Diabetes

Antibiotics can be of great help to a person who has diabetes. High blood sugar levels can negatively impact one’s immune system and weaken their defenses.

Those with diabetes are more prone to infections – even more so when the person has had prolonged diabetes and is experiencing reduced blood flow and nerve damage.

Moreover, high sugar levels can allow bacteria to grow more rapidly, allowing infections to develop faster.

Common Infections in Diabetics:

With this, it’s essential to know the common infections for people with diabetes. Here, you’ll find three: ear, nose, and throat infections, urinary tract infections, and skin and soft tissue infections.

Fungal infections in one’s ear, nose, and throat are common and almost exclusively for those with diabetes.

Severe symptoms can include ear discharge and severe ear and nose pain. One of the fatal infections in diabetics is mucormycosis.

Another common infection is the urinary tract infection caused by uncontrolled diabetes (which means one’s blood sugar levels are on the end although you’re already taking your prescriptions)—furthermore, these infections also cause inflammation in the kidney and bladder.

With the excessive use of SGLT-2 inhibitors (Jardiance and Farxiga), the incidence of urinary tract infections has increased. This is because these drugs cause glucose excretion into the urine.

Lastly, skin and soft tissue infections (including diabetic foot infections) are wounds in the leg due to poor or loose footwear. It could also be caused by repeated trauma to the area.

Diabetic foot infections are common because people with diabetic neuropathy do not feel pain.

When they have a trauma or an infection, they don’t realize it unless it’s too late. Diabetic foot infections can be serious requiring long-term antibiotics like Clindamycin, Moxifloxacin, Vancomycin, and Piperacillin-Tazobactam.


Should You Take Antibiotics?

Since you already know what antibiotics are and how they can potentially affect a person with diabetes, it all boils down to one last question: should you take antibiotics if you have diabetes?

Here, you need to ask yourself these three questions to determine whether or not adding this pill to your medication is viable.

Do I Know My Infection?

Not all infections are caused by bacteria and not all fevers mean infections. Infections can be caused by viruses and fungi as well.

Taking antibiotics for a viral fever can result in serious side effects. For example, if you have a fever and flu (caused by EBV or infectious mononucleosis) and you take amoxicillin, you may develop a severe skin rash.

Likewise, if you have a cough and phlegm, you may have asthma or allergies but if you start taking antibiotics for it, you may likely develop superinfections like fungal infections and C.defficile infections which can be life-threatening.

In addition, if you have diabetes and kidney disease, some antibiotics may cause more damage to your kidneys and you may end up on dialysis.

Lastly, you may be taking the wrong antibiotic and wasting your money as well as risking your life.

It’s not wise to impulsively buy antibiotics over the counter. Doing so can cause more damage since your doctor does not prescribe you.

Moreover, you’re not entirely sure if the antibiotic you’re buying will work for your infection, as different factors could also cause it.

With this, it’s always best to know your infection first by going to your doctor, taking medical tests, and buying the prescribed antibiotic. Furthermore, you should take the antibiotic as directed.

If your doctor tells you to take the pill in the morning, it’s best to follow suit and do so. There’s nothing better than stopping your infection by knowing it with the help of a licensed professional.


Commonly used antibiotics according to infection site:

Here is a table summarizing commonly used antibiotics according to the site of infection:


Common Infections


RespiratoryPneumoniaAzithromycin, Clarithromycin
Amoxicillin-Clavulanate, Ceftriaxone
Levofloxacin, Moxifloxacin
SinusitisAmoxicillin-Clavulanate, Doxycycline, Levofloxacin
BronchitisAzithromycin, Clarithromycin
Levofloxacin, Moxifloxacin
UrinaryUrinary Tract InfectionsNitrofurantoin, Trimethoprim-Sulfamethoxazole
(Lower and Upper)Ciprofloxacin, Levofloxacin
Amoxicillin-Clavulanate, Ceftriaxone, Piperacillin-Tazobactam, Cefoperazone-sulbactam
Aminoglycosides: Gentamicin, Amikacin
GastrointestinalGastroenteritisFluoroquinolones: Ciprofloxacin, Levofloxacin
Cefixime, Metronidazole
Helicobacter pyloriProton Pump Inhibitors: Omeprazole, Lansoprazole
Clarithromycin, Amoxicillin, Metronidazole
Tetracyclines: Doxycycline
Skin and Soft TissueCellulitisBeta-lactams: Dicloxacillin, Cephalexin
Clindamycin, Trimethoprim-Sulfamethoxazole
ImpetigoMupirocin, Retapamulin
Cephalexin, Dicloxacillin
Skin InfectionsDicloxacillin, Cephalexin
Clindamycin, Doxycycline
Erythromycin, Clarithromycin, Azithromycin
Central Nervous SystemMeningitisCeftriaxone, Cefotaxime
Ampicillin, Meropenem
EncephalitisAntivirals: Acyclovir, Ganciclovir
Ceftriaxone, Cefotaxime
Antifungals: Amphotericin B
Brain AbscessMetronidazole, Meropenem
Vancomycin, Ceftriaxone

It is essential to monitor your blood glucose if you are prescribed quinolones (levofloxacin, moxifloxacin, and ciprofloxacin). In addition, aminoglycosides should be avoided because of the risk of renal failure.

Other antibiotics may also need dose adjustments if you have kidney problems, heart disease, or liver impairment.

Lastly, metformin, acarbose (Glucobay), and other diabetes medications like GLP-1 analogs (Ozempic, Mounjaro, Rybelsus, Trulicity, and Victoza) can impair the absorption of oral antibiotics. There is also an increased risk of GI side effects.

Before you start taking antibiotics, talk to your doctor about these potential drug interactions, side effects, hypoglycemia, and your comorbid medical conditions.

Should I Check My Blood Sugar Levels?

Some antibiotics can cause one’s blood sugar levels to fluctuate higher or lower – one of which is fluoroquinolone, a variation that eases UTI infections and can alter sugar levels.

To be safe, it’s best for you to regularly check your blood sugar levels when you’re prescribed a new antibiotic.

Once you’re prescribed a new antibiotic pill, it would be best for you to ask your doctor about this effect.

You could inquire if you’re most likely to experience an elevated blood sugar level and if other pills could refrain from doing so.

You could even ask how often you should check your blood sugar levels and take extra precautions.

Do I Know the Side Effects?

Experiencing an elevated sugar level is one thing. However, you could also experience other side effects, such as cramps and fever.

You could also experience antibiotic hypersensitivity, which includes breathing difficulties and irregular heartbeats.

Although these symptoms come with higher antibiotic dosages, it’s best to seek your doctor if they appear, even with a lower dosage pill.


Final Thoughts

Antibiotics can be beneficial in treating infections due to the weakened immune system caused by diabetes.

Furthermore, asking your doctor about the pill, side effects, and dosage is best before adding this pill to your routine.

Doing so will help you learn about your condition from a professional’s perspective and help you efficiently target infections and inflammations.


What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

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