Sunday, June 14, 2015

The law of unintended consequences

Original post:  May 15, 2014

Sometimes our best efforts can lead us in directions that we don't necessarily want to travel. Some of the most dangerous threats to our health are caused by the very items that we had hoped to use to shield us from these menaces.

This article from Ars Technica discusses one such situation. It reviews a new book by Martin Blaser titled "Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues."

While antibiotics have helped us tremendously, the author cautions that these same wonder drugs are also disrupting the complicated nature of the human biome. In addition to killing the harmful bacteria, we may also be wiping out the helpful ones as well.

I have a personal experience that underscores this theory. One of the worst experiences in my life was undergoing treatment for a stomach ailment while in the Army. They treated me with large doses of antibiotics that wreaked havoc on my digestive system. I think it took me months to get back to feeling normal. Perhaps it was because the antibiotics killed all of the normal flora that my body had cultivated over the years to protect me!

Here is a key excerpt from the article:

The hidden cost of our profligate antibiotic overuse is a prominent theme in this book. Blaser started his career as an infectious disease guy and he did his time at the Centers for Disease Control; he knows full well the damage pathogens can wreak, and just how essential antibiotics are to maintaining public health. This is another reason he advocates curbing antibiotic overuse: to reduce antibiotic resistance, so these drugs will still work when we really need them.

By treating every childhood sniffle with broad spectrum antibiotics, we are killing not only dangerous pathogens but also the hundreds of trillions of bacteria that live in our bodies and have been there ever since the dawn of humanity. He thinks that those species are there for a reason, and he warns that their demise is causing big trouble—with more to come.

Ironically, antibiotic exposure has also been shown to increase susceptibility to subsequent infection, possibly because of the effects that perturbing the microbiome has on immunity.

The author thinks that one of the most important reasons to minimize the use of antibiotics is to preserve bacterial diversity:

Our bodies have ten times more bacterial cells than human cells. There might be trillions of cells of some species—like Bacteroides—but only a few hundred cells of rarer species. As in any ecosystem, biodiversity provides robustness.

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