They have a rightful place in the doctor’s toolkit, it’s simple, they are life-saving. In some instances, they are the only treatment option available. However, there is a strong case with research to support it, that antibiotic pretreatment increases susceptibility to pathogenic strains of bacteria. How? A five-day course of antibiotics can suppress as much as 1/3 of your gut bacteria, this provides an opportunity (more car parking spaces open up) for other microbial strains to increase their presence.
Gut microbiota recovery from antibiotic therapy is a new area of research. Can we identify bacterial families that are associated with a faster and more sustained microbiota recovery? This is the future.
Is the rise in antibiotic resistance due to overprescribing? Or is it related to the fact that we consume products from animals that are given antibiotics to promote growth? Why are Clostridium difficile (C.diff) infections and methicillin resistant Staphylococcus aureus (MRSA) infections that used to be confined to hospitals now appearing in western communities? In Asia, resistant bacteria tend to be Enterobacter and Klebsiella. The emergence of these resistant bacterial strains demonstrates that over decades and millions of courses of antibiotics, we are exerting selection pressures on these microbes. This causes the most toxic bacteria to survive, replicate and transmit their genetic codes both down their species line and also potentially across to other species.
There have been significant inroads made to influence and ultimately reduce the prescribing practice of doctors around the world but this requires patients and parents to support and understand the importance of judicious antibiotic prescribing.
If you are prescribed antibiotics:
Finish the course! Do not take five or six doses of an antibiotic course and then stop because you or your child are feeling better. You are potentially influencing the ability of the bacteria to develop full resistance to that antibiotic. Resistant bacteria can colonise the gut but not necessarily demonstrate any negative symptoms.
Ask for the narrowest spectrum antibiotic possible to reduce the collateral damage to other beneficial gut microbes.
Discuss the absolute need for ‘prophylactic’ antibiotic use with your healthcare professional e.g. for a dental procedure or a simple excisional skin procedure
Do take probiotics and fermented foods, but space them 2-3 hours from the antibiotic dose and continue them after the antibiotic course is finished.