Bug cul­ture

Winnipeg Free Press - Section G - - BOOKS -

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.

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