First, a harmless question: how many courses of antibiotics have you taken in your life?
Since the early 20th century, antibiotics have long been hailed as miracle drugs, capable of treating bacterial infections and saving lives. And while they have without doubt saved many lives, recent research is shedding a very concerning light on the darker side of these medications, revealing they may be far more damaging to our health than previously believed. The negative effects are absolutely not related only to the antibiotic resistance (meaning that we are facing an era where common infections could become untreatable and deadly due to overuse and misuse of antibiotics). It goes far beyond that and there are very good reasons to think that antibiotics have long-lasting negative impacts on us.
Imagine an experiment in which a couple of generations, that is you, your parents and your grandparents repeatedly take a medication with an effect that had not been seen ever before for thousands of years. Now multiply this idea with hundreds of millions, billions of people affected – almost all of the humanity living in the modern western world (except for people that for some reason never needed any antibiotics).
What effect are we talking about in this big experiment?
We will call it a microbiome disruption and we should be rightfully concerned about it. The human microbiome, consisting of trillions of microbes in our bodies, plays a crucial role in maintaining our health. Antibiotics, while targeting harmful bacteria, also disrupt the delicate balance of beneficial microbes in the gut and other parts of the body. They can diminish or wipe out our native microbes that had been present in our bodies and evolving with us for endless generations before the present day. This disruption can have far-reaching consequences, impacting digestion, immune function and even mental health or metabolism. (By the way, did you know that it is/was a established practice to give antibiotics to agricultural animals such as cows or pigs, in order to increase their growth and weight gain - to make them fatter?)
What we are talking about here are not the usual and familiar gut problems such as diarrhea lasting (hopefully!) just a few days when taking antibiotics. The scope of the negative effects goes far beyond just that and the damage may be long-lasting. Sure, after a particular course of antibiotics, some people and their microbiomes may recover, some better, others worse, there are many factors and it is not really possible to predict that practically (yet). Nevertheless, it’s always a dangerous game - playing with a delicate mechanism.
Our world is facing a growing epidemic of chronic diseases, with conditions like type 1 diabetes, gastroesophageal reflux disease, asthma, inflammatory bowel disease, and particularly obesity on the rise. While there are many factors at play, the use and overuse of antibiotics might be precisely the major contributor to this decline. We are disrupting the delicate ecosystem within our gut, and it's likely having a devastating effect on our overall health.
It's not just my hypothesis. The science is already out there, quickly piling up and the image is getting ever clearer. The gut microbiome disruption has been already strongly implicated for the above mentioned (and also other) diseases in research [4][8]. Even a short-term antibiotic treatment is able to change the richness and diversity of gut microbiome species into a long-lasting dysbiotic, imbalanced state [1]. As few as 3 days of treatment with the most commonly prescribed antibiotics can result in sustained reductions in microbiota diversity, which could have implications for the maintenance of human health and resilience to disease [3]. The resulting damage may or may not be readily apparent, it could be subtle. It may manifest itself later, perhaps as seemingly non-related issues [4][7].
Also, contrary to popular belief, taking a probiotics after a course of antibiotics does not undo the damage caused by the antibiotics. In fact, sometimes it may even be counter-productive, delaying the recovery of the gut microbiome [5]. Probiotics simply cannot easily undo the damage of such a complex system as the gut microbiome.
Taking an antibiotic can be likened to a forest fire, where the forest represents a complex ecosystem of the gut microbiome.
It is all even more concerning if we think about the fact that to a significant degree, a mother’s microbiome is passed on to her child, and it can affect child’s later health. This means that the impact of antibiotics on our bodies may not completely reset with each new generation. All in all, the damage from antibiotics may very well be hereditary and hard to correct in the next generations.
And this whole thing can get to a vicious cycle rather easily: we are getting sicker due to bad diet, bad environment, stressful lives and - due to taking antibiotics (possibly in cases when they were in fact not even necessary or effective!). Then we are more likely to get sick and need (or „need“) more antibiotics, again possibly further damaging our microbiome, immune system, or among others, e.g. ability to digest certain foods, again getting proner to perpetuating the cycle.
Misuse and over-prescription of antibiotics has its price. Many people have already found this out the hard way. How many people have been damaged by being repeatedly prescribed antibiotics (which were possibly not even effective or necessary in the first place at all), after which their health went terribly downhill and it took them a long time, even years to get their health and life together again? That is, if they succeeded at all. How many kids have been carelessly stuffed full with antibiotics in their childhood, just to grow up into a compromised health, prone to developing various health problems, or perhaps let's say an obesity and being blamed for it? Of course, the link to their damaged guts might have been never discovered. Also, how many people's health has been terribly damaged, for example by the infamous antibiotic Ciprofloxacin with serious side effects and the likes?
I and other people I know could have something to say about that.
If we want to keep ourselves - and the society as such - in a good health, this topic is not to be taken lightly and should get far more spotlight. A lot of damage has already been done.
See my related article about the role of microbiome in your health
Literature - just a small selection:
[1] Fire in the Forest: Adverse Effects of Antibiotics on the Healthy Human Gut Microbiome
https://www.ijmedrev.com/article_76662.html
[2] Antibiotics administered to mothers during childbirth linked to autoimmune diseases in children: Risk of immune-related diseases in childhood after intrapartum antibiotic exposure
https://medicalxpress.com/news/2024-02-antibiotics-mothers-childbirth-linked-autoimmune.html
[3] Microbial diversity in individuals and their household contacts following typical antibiotic courses
https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0187-9
[4] Our missing microbes: Short-term antibiotic courses have long-term consequences
https://www.ccjm.org/content/85/12/928
[5] Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT
https://www.cell.com/cell/fulltext/S0092-8674(18)31108-5
[6] Antibiotic use in the past 8 years and gut microbiota composition
https://www.medrxiv.org/content/10.1101/2024.10.14.24315441v1
[7] Antibiotics found to weaken body's ability to fight off disease
https://www.eurekalert.org/news-releases/684202
https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006513
[8] Association of Infant Antibiotic Exposure With Childhood Health Outcomes: "Early antibiotic exposure was associated with an increased risk of childhood-onset asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder".
https://www.mayoclinicproceedings.org/article/S0025-6196(20)30785-0/fulltext