August 4, 2014 in City

The Rock Doc: Antibiotics must be used carefully

E. Kirsten Peters
 

It’s astonishing to think about, but when my grandfather was born, tuberculosis was the No. 1 cause of death in our country. Worse still, one in five children didn’t live to see their fifth birthday, in large part due to endemic and epidemic diseases. Today that’s all changed.

Although doctors can often do a great deal, it’s also true that chronic diseases plague us. And a number of these maladies seem to be on the rise, including diabetes, asthma, celiac disease, food allergies and especially obesity.

Dr. Martin Blaser of New York University thinks he understands part of what’s going on. Medical treatments themselves are contributing to the rise of some chronic health problems, Blaser believes. His new book, “Missing Microbes: How the Overuse of Antibiotics is Fueling our Modern Plagues,” explores the link between changes in our internal microbes and the chronic diseases so many of us face.

Antibiotics are a blessing. But if Blaser is right, they are also a curse. To take just one malady, let’s focus on obesity.

Back in 1990, about 12 percent of people in the U.S. were obese. The figure has grown to about 30 percent.

Your body is host to many trillions of microorganisms that change over time. The number of bacteria in your mouth are altered depending on whether you breathe through your nose or mouth. That’s because some microorganisms can’t live in the presence of oxygen. At night, you breathe mostly through your nose and the proportion of bacteria in your mouth that don’t cope with oxygen can increase, giving you bad breath when you wake up.

Important changes in populations of microorganisms occur when we take antibiotics to eradicate what’s making us ill. But as Blaser points out, useful microorganisms also are affected by antibiotics.

I was surprised to learn from his book that most antibiotics do not end up in our pills, but go into the cattle, swine and poultry we eat. The animals gain more weight when on antibiotics.

For humans, too, antibiotics, especially those given to kids, may be leading to more growth and to putting on more fat, including in later life. The book reviews experiments with mice in Blaser’s lab that address this connection, as well as studies in human populations. Blaser concludes we may be inadvertently fattening up our young in our rush to use antibiotics to treat every sore throat or cough.

As Blaser sees it, antibiotics contribute to obesity and a host of other chronic diseases that have been on the rise in recent decades. He argues that our attitudes need to change. Doctors should be trained to think twice before prescribing antibiotics. The drugs should be reserved for serious conditions.

“Doctors and patients alike have never fully taken into account all the costs of using antibiotics. Once they do, I predict their use, especially in early childhood, will greatly diminish,” Blaser wrote me.

No one wants to go back to the problems that were common when my grandfather was born. But it’s time we looked at what the overuse of antibiotics may be costing us.

Dr. E. Kirsten Peters was trained as a geologist. This column is a service of the College of Agricultural, Human, and Natural Resource Sciences at Washington State University.


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