The Downside of Antibiotics
Updated: Aug 22, 2020
Have you used an antibiotic in the past six months? The past year? The past 5 years? How about in your lifetime? Have your kids taken antibiotics? Repeatedly? Antibiotics, once a class of wonder drugs, are now understood to have negative health implications for patients who take them. In a modern, westernized country like the United States, antibiotic use is widespread. The CDC documented that in 2015, over 2.5 billion antibiotic prescriptions were written in the out-patient sector in the US alone not including the prescriptions made within hospital settings. That is a crazy number, especially considering that the CDC deems that at least 30% of these prescriptions were unnecessary. Some of the core issues with these medicines have been known for quite some time now: bacterial resistance over time rendering the antibiotics less and less effective, and the ecological impact of widespread antibiotic use (contamination of the water supply, use in livestock, etc.). These issues are often discussed, but the conversation is cut short in the doctor’s office. Long-term consequences to the environment because of heavy antibiotic use is obviously not the doctor’s immediate concern. Rather, her immediate concern is her sick patient. This becomes a particularly big problem when in the conventional community, antibiotics are often seen to be the only tool with which to address an acute illness.
In contrast, within the naturopathic and functional medicine communities, other non-antibiotic therapeutic tools have been considered in acute settings for many decades. One of our primary reasons for utilizing alternative treatment strategies relates to another important health issue which has been burgeoning in medical research over the last number of years, and is making headway even with our conventional colleagues. And that reason is…. …The impact that antibiotics have on the microbiome! Your body is made up of microbes more than it is of human cells. This is true of your skin, your intestinal tract, your nasal/respiratory tract, urinary tract, vaginal tract, and other barrier surfaces in the body.
As it turns out, these microbes play a fundamental role in just about every bodily function that we have - regulating the immune system, optimizing metabolism, ensuring absorption nutrients, ridding the body toxic waste, regulating hormones, etc.. And when we “play God” with these microbes by killing them off indiscriminately, we pay consequences. Studies repeatedly show that when exposure starts early in life or occurs often, antibiotics increase the risk of developing a whole host of problems including obesity, diabetes, allergic disease, autoimmune diseases, and others. Importantly (and somewhat ironically), antibiotic exposure also reduces our ability to stave off future infections! What we eat and how we live also play a key role in disease risk, but the health and diversity of our microbial communities within our bodies are equally paramount.
Have you taken a 5 day course of antibiotics lately? How long do you think that course of antibiotics will impact your internal ecosystem? No doubt we will continue to see studies on this topic, but we know already from several that we see a negative impact on microbial diversity for months after the end of a round of antibiotics. If you are using antibiotics multiple times per year, and if your daily exposure to probiotics and prebiotics (probiotic “fertilizer”) is low, you can imagine how easily this incredibly important ecosystem can deteriorate. Is there a solution to this problem?
Certainly, there are many situations where antibiotics are still necessary and effective. My intention is not to downplay this or demonize antibiotics. They are an extremely important therapeutic tool. Rather, my intention is to acknowledge that there are also very effective non-antibiotic approaches to be utilized as a first-line defense for uncomplicated, simple infections. I also emphasize the benefit of taking a holistic, preventative approach to addressing infection-susceptibility. In other words: Let’s do a better job of strengthening an individual’s ability to resist infection when “bad bugs” present themselves, and let’s utilize our entire toolbox to treat acute infections including non-antibiotic treatments. This combination approach to treating acute illness helps to avoid future antibiotic resistance AND protects the microbiome from antibiotic assault. In my practice, this means that I employ key immune-regulating nutrients like Vitamin D, Vitamin C and Vitamin A as well as my arsenal of botanical medicines like Andrographis, Osha and Elderberry, to name a few. These medicinal herbs and nutrients are effective not only because they have direct anti-bacterial and anti-viral effects, but also because they augment your own immune system’s ability to naturally combat infections. What could be better than that?!
Because of all of these issues, antibiotic use as we know it is inevitably going to change. New medicines will emerge, and algorithms guiding doctors’ prescription choices will evolve. I suggest that the role of functional medicine doctors like myself will become increasingly necessary as we navigate this new era of antibiotic resistance and antibiotic-induced health problems.
In Health, Dr. Otto