Too Good To Be True: Antibiotics Not As Benign As We Thought
Most of us view antibiotics as common, somewhat unremarkable tools in the modern medicine chest. Few people are alive today who can remember life without antibiotics. Those who do will recall a time when even the smallest of mishaps could spell painful death. In fact, the very first patient ever treated with an antibiotic was a gentleman who’s finger became infected when he pricked his skin on a rose thorn.
Penicillin was under development, and scientists had just enough of the precious drug for a single dose. The patient was suffering from a raging infection, yet he began to rally after that initial dose. Unfortunately, there was not yet enough of the drug to provide a second, or third dose. His infection resurged, and the patient eventually died. From a thorn prick.
That was life before antibiotics. Anyone could be felled by even the simplest of infections. Needless to say, once antibiotics could be mass produced, they ushered in a new era in medicine. Once-common infections were no longer a death sentence. Common strep infections no longer progressed to cause deafness, or to inflame the lining of the heart. It was a modern miracle. Even better, antibiotics appeared to be perfectly safe and well tolerated, with few side effects. Some people were allergic to certain early-generation antibiotics, but subsequent generations of antibiotics followed, often eliminating that particular problem.
There were hints of trouble in paradise, though. Some early testing, on healthy young American service personnel, turned up a curious side effect. Men who took the new antibiotics invariably gained weight.
And it didn’t take long for overuse to cause certain dangerous bacteria to develop resistance. This is why it’s crucial to always take one’s full course of antibiotics. If you stop too soon, even if you feel better, the strongest bacteria may live to proliferate, creating an all-new generation of drug-resistant bacteria, capable of infecting others—yet immune to the effects of antibiotics.
But the real problem has to do with antibiotics’ effects on our own friendly bacteria. Most antibiotics kill indiscriminately. That means our gut bacteria can be devastated by a course of antibiotics. When entire classes of friendly bacteria perish, other, less-friendly bacteria are free to move in and take up residence.
Recently Oregon State researchers published an article that addressed some of these concerns. "Just in the past decade a whole new universe has opened up about the far-reaching effects of antibiotic use, and now we're exploring it," said Andrey Morgun, an assistant professor in the OSU College of Pharmacy.
"Prior to this most people thought antibiotics only depleted microbiota and diminished several important immune functions that take place in the gut," Morgun said. "Actually that's only about one-third of the picture. They also kill intestinal epithelium. Destruction of the intestinal epithelium is important because this is the site of nutrient absorption, part of our immune system and it has other biological functions that play a role in human health.”
Digestion problems are only the tip of the iceberg. Emerging research has linked antibiotic use to everything from obesity, food absorption, and depression, to immune function, sepsis, allergies, and asthma.
While I certainly wouldn’t advise anyone to refuse antibiotics if they’re truly needed, I think there’s now plenty of evidence that we need to rethink our relationship with these over-used drugs. They can save a life, but they can also affect long-term health in ways that we’re only beginning to understand. At the very least, it may be prudent to take a follow-up course of probiotics the next time you have to take antibiotics. Probiotics are friendly bacteria of the sort found in yogurt, kefir, and other fermented foods. They can help re-establish a healthy gut microbiome in the wake of antibiotics’ indiscriminate killing.
Morgun, A. Dzutsev, X. Dong, R. L. Greer, D. J. Sexton, J. Ravel, M. Schuster, W. Hsiao, P. Matzinger, N. Shulzhenko. Uncovering effects of antibiotics on the host and microbiota using transkingdom gene networks. Gut, 2015; DOI: 10.1136/gutjnl-2014-308820