YSK: Do You Really Need That Antibiotic? It’s antibiotic season. Brush up on how you should use them — and when to avoid them. (NYT, Dec 2023)
YSK: Do You Really Need That Antibiotic? It’s antibiotic season. Brush up on how you should use them — and when to avoid them. (NYT, Dec 2023)
It’s antibiotic season. Brush up on how you should use them — and when to avoid them.
It's refreshing to see a major news outlet discussing collateral damage and not just resistance. Over the past decade, 99% of the time antibiotic overuse is covered and warned about it's always only in regards to resistance.
It's a good article that also doesn't spread the common misinformation of "just take some probiotics and fermented foods after antibiotics and you're good to go".
Swallowing an antibiotic is like carpet-bombing the trillions of microorganisms that live in the gut, killing not just the bad but the good too, said Dr. Martin Blaser, author of the book “Missing Microbes” and director of the Center for Advanced Biotechnology and Medicine at Rutgers University.
“I think the health profession in general has systematically overestimated the value of antibiotics and underestimated the cost,” Dr. Blaser said.
No shit. And it has spread like a virus to the general populace as well. The majority of people seem mentally addicted to antibiotics and think they're going to die if they don't get an antibiotic for every minor issue.
- Find out if you really need an antibiotic.
- Ask for the shortest course.
- Rethink probiotics.
I appreciate the NYT for finally helping spread this.
Just yesterday people on Lemmy were cheering about AI discovering new antibiotics. When I shared info about the concerns of collateral damage, the responses were more unintelligent and close-minded than on reddit. Extremely depressing.
For more info on this subject there's a wiki and forum at https://humanmicrobiome.info.
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Some relevant info I shared yesterday:
Resistance can be solved by restoring lost microbes with FMT: https://humanmicrobiome.info/antibiotics/
That's not exactly true. FMT isn't going to fix your MRSA colonization, and it doesn't inherently remove resistance genes from the population of bacteria in your gut. If those genes produce a survival disadvantage, they may be selected against and become a minor serotype in your GI tract, but that doesn't mean that it is eradicated.
Also, you seem to be sharing a lot of links from humanmicrobiome.info, which I would advise against. While I can appreciate the primary author's dedication to the topic and willingness to cite his sources, his website is not peer reviewed, and he explicitly states he is a proponent of FMT, introducing bias which is not being balanced by a peer review process. Not to mention he admits he is a layperson with no formal medical training/experience. I would direct you to IDSociety.org which is the home of the Infectious Disease Society of America, who publishes the actual guidelines used by infectious disease physicians in North America.
MRSA is actually covered in the cited links. Here's one for example https://academic.oup.com/ofid/article/6/7/ofz288/5522275.
The gut microbiome regulates the entire body, including the immune system and other body site's microbiomes https://humanmicrobiome.info/systemic. You can see what a great resource it is -- very handy to provide categorized citations.
his website is not peer reviewed
Anyone is welcome to contribute and peer review it.
Yes, it covers intestinal colonization with MRSA. Unfortunately Staph aureus is an uncommon GI pathogen, and the majority of detrimental infections secondary to MRSA come from skin-flora translocation to produce surgical site infections/blood stream infections, as well as translocation from the nares into the lungs to produce pneumonia. We thankfully have another method of nares decolonization. While metallobetalactamase producing Pseudomonas is mentioned as well, I have a very low suspicion that FMT would be useful for resistant Pseudomonal pneumonia or diabetic foot infections/osteomyelitis. FMT certainly has a role to play in ID, particularly for enteric gram negatives and VRE within the alimentary canal, but is not a cure-all for antimicrobial resistance.
For anyone wondering, FMT = Fecal Microbiota Transplants.
It's exactly what it sounds like; through oral or rectal.
I imagine burping after taking it through the oral route would be a special kind of horrible