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.
The shortest course is bad advice. When you do take antibiotics, you don’t want to create antibiotic resistant bacteria.
That’s why they tell you to always take the full course, even if you feel better.
tl;dr - Asking your doctor for the shortest reasonable course is a good thing that will both protect you as a patient as well as minimize your risk of antimicrobial resistance. But the key phrase is ask your doctor, do not take it upon yourself to decide when to stop them. Take whatever course you’re prescribed.
Pharmacist and 4th year medical student with a passion for antimicrobial stewardship and infectious disease.
Historical treatment duration for most infections was truly quite arbitrary. Evidence for most infections, when it is actually tested, have pretty consistently demonstrated shorter treatment durations than were classically taught (10-14 days for pneumonia now generally 5-7, 14 days for Gram Negative Bacteremia now 7, etc). There is a subset of infectious disease doctors that are bucking the trend of historical “you have to complete your course advice” for some infections. In general, what I have seen is recommendations to discontinue antibiotics with significant clinical improvement AND a non-life-threatening infection in a non-sterile body cavity. So nobody is shortening course durations for empyemas or endocarditis.
The issue becomes expecting patients to know what constitutes clinically meaningful recovery and whether or not their infection is one of the “safe” ones to stop antibiotics earlier.
At the end of the day, I totally disagree with your premise, as we should always strive for the minimum safe antimicrobial exposure. However I do agree that telling patients “shorter is better” is bad advice because I don’t want laypeople making these decisions when usually no-ID physicians don’t make them.
deleted by creator
Yup, it’s hard to have a good discussion about the changing tides in ID without feeling like you’re causing a bunch of backsliding and non-compliance. I think being honest with people that the data is generally poor about how we select durations is the moral thing to do. But I do want you to just take your damn antibiotics as prescribed instead of going rouge because you heard “shorter is better” and your pneumonia recurring.
WITH CITATIONS.
“finish your fucking course” is wrong, and pigheaded people that refuse to review scientific evidence and reshape their opinions accordingly do a lot of harm and make it impossible for the scientific method to work and for the scientific community to update the public when the evidence and consensus changes.
deleted by creator
I’m not as confident as you are in the evidence-based nature/abilities of doctors. See https://forum.humanmicrobiome.info/threads/doctors-are-not-systematically-updated-on-the-latest-literature-what-t.27/
You’re citing forum posts to discussions (with some evidence mentioned within) to support this supposition that doctors are horribly informed and out of date. But I’d like to point out that this is being vastly overblown, and even a 5-10 year out-of-date medical professional has immensely more knowledge and safe ability to recommend therapy than a layperson. I can’t pretend to know the credentials of the individual you’re responding to, but they’re clearly well versed in clinical infectious disease based on their comments, and you’re not supporting your position by citing a forum instead of the actual primary literature that supports your position.
I know from a plethora of experience that this is wrong. It’s also way too broad of a claim. Laypeople knowledge varies a lot. I know first-hand of some laypeople who are actually top experts in scientific/medical fields and I know of people with medical degrees who promote themselves as experts in their field yet they spread harmful misinformation that severely harmed patients and nearly got them killed.
I think this is poorly worded, but I think I still understand what you were trying to say. There is no reason for me to duplicate the forum post here. There are citations there. Copying them here doesn’t make them more legitimate.
deleted by creator
That’s wrong. Stop confidently spreading harmful misinformation. I already provided citations that you should have checked before making that statement: https://humanmicrobiome.info/antibiotics/
EDIT: And to all the people who upvoted the person I’m responding to, you should not be upvoting people who make medical/scientific claims without a citation, especially when they’re contradicting a highly reputable news source (NYT) that contains scientific citations and expert commentary.
The real information is to ask your doctor and be careful with advice from social media.
Yes and no. https://forum.humanmicrobiome.info/threads/doctors-are-not-systematically-updated-on-the-latest-literature-what-t.27/
deleted by creator
Wrong. Also irrelevant. It contains a plethora of scientific citations, which is all that matters.
Gibberish that tells me you don’t know what you’re talking about, but want to sound authoritative.
deleted by creator
I would like to point out, the NYT is a reputable news site but cannot even remotely be trusted with medical information/recommendations. I can’t tell you the last time I read a medical news piece from any source (and the NYT is the primary place I get my news) that I couldn’t read it and say “well that’s a gross oversimplification” or worse “this is blatantly misrepresenting the scientific author’s conclusions”. Holding up the NYT as a source of medical/scientific truth is just demonstrating how scientifically illiterate you really are.
Wow, projecting hard with that comment. This is a fantastic and well-cited article, and your comment does nothing to debunk anything in it, and you end with a baseless “you’re scientifically illiterate” comment. Amazing.