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A study done on rats by the National institute on Alcohol Abuse and Alcoholism found that alcohol doesnât prevent azithromycin from killing your bacterial infection. But, drinking alcohol can cause temporary liver damage in some people. That may increase the severity of unpleasant side effects. Alcohol is also dehydrating. A hangover would worsen the nausea, vomiting, and headache that azithromycin may trigger.
Most antibiotics can be mixed with moderate amounts of alcohol with no problem. At most, they'd enhance some of the antibiotics' secondary effects like dizziness - but it's unlikely to happen if you don't suffer from any of these effects and don't overdrink. Some antibiotics (like metronidazole and TMP-SMX) can have a stronger reaction to alcohol, causing headaches and nausea. But even then, alcohol doesn't reduce the antibiotics' effectiveness. Now, what alcohol (especially in large quantities) will do is slow the healing process.