Antibiotics don’t discriminate between the good guys and the bad guys, and the most popular drugs are the ones that cast the widest net. The writing, while unpolished, is clear and accessible. It isn’t meant to be literature; it’s a book with an important message that is spreading as more people listen. Awareness is growing about the dangers caused by overuse of antibiotics. This April, the World Health Organization released a high-profile report on the subject, which was covered by newspapers the world over, including the Free Press. The warnings centre around the emergence of antibiotic-resistant pathogens: CRE, clostridium difficile, drug-resistant gonorrhea and MRSA are at the top of a growing list. The use of antibiotics creates a strong evolutionary pressure in our bodies that favours any organisms that are able to survive the onslaught. The emergence of these pathogens may have been inevitable, but the swiftness of their arrival was alarming and, in hindsight, avoidable. Blaser notes many physicians have been profligate with prescriptions for amoxicillin, tetracycline and other bacteria killers. For a long time, conventional wisdom was that they had little to no downside, and were given as a “just in case” measure, even if an ailment was probably viral and non-serious. The biggest consumer of antibiotics is outside the clinic — 70 to 80 per cent of antibiotics in the U.S. are sold to the agricultural industry “by the ton rather than by the milligram.” There, antibiotics are given to livestock at sub-therapeutic doses to fatten them up with less feed. For a slightly lower price on beef, pork and turkey, we may be paying a much steeper price in the near future. The case against antibiotics often focuses on long-term concerns like new and dangerous diseases and unstoppable infections, while the immediate risk has been less publicized. The middle chapters of his book detail Blaser’s research into the human microbiome, and seek to correct this. Not only do antibiotics lead to new pernicious diseases, but those who take them are much more likely to get those diseases. By killing off a wide assortment of our bugs, including many good ones, a patient’s immune system is weakened and microscopic niches in their body are left unoccupied and ripe for infection. Moreover, the use of antibiotics, especially on young children, has been correlated to a laundry list of modern plagues, such as inflammatory bowel disease, asthma, eczema, celiac disease and even obesity (think of those farm animals putting on extra pounds thanks to antibiotics). Correlation doesn’t mean causation, but Blaser’s research has made these connections plausible and at the very least, worthy of more study and attention. Missing Microbes is an excellent introduction to what has become one of the central health crises of the 21st century. The reader will have multiple reasons, both altruistic and selfish, to think carefully before asking for an antibiotic prescription.
Paul Klassen is a Winnipeg engineer.