this post was submitted on 22 Dec 2023
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It's refreshing to see a major news outlet discussing collateral damage and not just resistance. Over the past decade, 99% of the time antibiotic overuse is covered and warned about it's always only in regards to resistance.

It's a good article that also doesn't spread the common misinformation of "just take some probiotics and fermented foods after antibiotics and you're good to go".

Swallowing an antibiotic is like carpet-bombing the trillions of microorganisms that live in the gut, killing not just the bad but the good too, said Dr. Martin Blaser, author of the book “Missing Microbes” and director of the Center for Advanced Biotechnology and Medicine at Rutgers University.

“I think the health profession in general has systematically overestimated the value of antibiotics and underestimated the cost,” Dr. Blaser said.

No shit. And it has spread like a virus to the general populace as well. The majority of people seem mentally addicted to antibiotics and think they're going to die if they don't get an antibiotic for every minor issue.

  • Find out if you really need an antibiotic.
  • Ask for the shortest course.
  • Rethink probiotics.

I appreciate the NYT for finally helping spread this.

Just yesterday people on Lemmy were cheering about AI discovering new antibiotics. When I shared info about the concerns of collateral damage, the responses were more unintelligent and close-minded than on reddit. Extremely depressing.

For more info on this subject there's a wiki and forum at https://humanmicrobiome.info.

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[–] [email protected] -1 points 9 months ago (1 children)

as to effectively use phage therapy you must identify the organism and then select appropriate phages which will kill the bacteria, which takes time that a sick patient may not have without antibiotics

Phage cocktails, FMT, etc... Also, we should get better at speeding that process up if we fund research for it, but we've been instead continuing to rely on antibiotics.

We also haven’t quite figured out how to keep our immune system from eradicating the bacteriophages

Citation? I don't recall that being a thing... phages are ubiquitous in the human body. As much or more so than bacteria. They are the natural way bacteria are kept in check.

[–] [email protected] 4 points 9 months ago* (last edited 9 months ago)

Section 2, first paragraph. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956183/

At their core phages are viruses, there is no reason to expect the host immune system to not recognize them as foreign and attempt to eradicate them outside the GI tract, where most serious infections occur. The GI tract, skin, and to some extent the lower UG tract will likely tolerate these through mechanisms we tolerate colonizing bacterial flora, but colonization, even with antibiotic resistant organisms, is not a primary indication for empiric treatment for eradication. In fact there are some studies that attempting to sterilize the UG tract in colonized asymptomatic women promote symptomatic UTI.

These colonizations become problematic when growth becomes unchecked and infection develops, or they seed infection into another compartment. There is no reason to think something as foreign as a bacteriophage wouldn't be recognized as foreign in a sterile space (kidneys for pyelonephritis, liver abscess from migrated gut flora, endocarditis, etc) where these serious infections occur.

This ties in nicely with your suggestion of phage cocktail therapy. Yes, that can expedite the delivery of phages, however excessive use of phages could result in anti-phage antibodies, limiting future treatment in a method similar to the development of anti-drug antibodies in epoeitin analogues, insulin therapy, antivenin, and anti-inflammatory antibody therapies like adalimumab (Humira)