Antibiotics are crucial for both individual and public health. They help us get better when we have an infection, they prevent us from infecting others by decreasing our infection time, and ultimately, they save lives. However, as the saying goes, too much of a good thing can be bad, and this principle also applies to antibiotics. Enter: antibiotic overuse.
We as a society have become reliant on antibiotics as a quick fix for anything that ails us. Many patients visit their doctor’s office or have a telemedicine appointment in hopes of getting a coveted antibiotic prescription, whether they think they might have a sinus infection, urinary tract infection, or bronchitis. Some patients will ask –– or even demand –– their doctor to prescribe them an antibiotic, even after they initially say, “no.” Maybe you are even guilty of doing this yourself once or twice in the past. A lot of us are!
Why Antibiotics Aren’t Always Necessary
Doctors aren’t trying to be mean or keep you from feeling better when they deny you antibiotics. In fact, they’re trying to help! Doctors hesitant to write prescriptions for antibiotics when they aren't absolutely necessary are doing you a favor, trying to limit the impacts of antibiotic overuse, which are twofold. First, antibiotic overuse can have negative effects on your gut’s microbiome and thus, your overall health. Second, antibiotic overuse can contribute to antibiotic resistance, which can have large-scale detrimental effects.
This isn’t to say that antibiotics should never be prescribed. Antibiotics are absolutely warranted in many situations, especially in severe cases, like a ruptured appendix, or when there’s been testing done to confirm a certain type of bacteria is truly present, if you have confirmed strep throat, says functional medicine doctor Tejal Joseph, MD.
However, in many, many cases, Dr. Joseph says the cause of the patient’s illness is a virus, not a bacteria, in which case antibiotics won’t do any good, since antibiotics kill bacteria, not viruses. For example, many patients seek medical consultation for upper respiratory infections (AKA the common cold), asking for antibiotics to help them get better quickly. Unfortunately, antibiotics aren’t the answer.
Still, antibiotics are prescribed by doctors in cases where they really aren’t necessary. For example, one 2019 study of 19.2 million US patients found that only 23.2% of their antibiotic prescriptions were inappropriate, and 35.5% were potentially appropriate. In these circumstances, where an antibiotic is not truly justified, more harm may be done than good.
Impacts of Antibiotic Overuse on Your Gut
Did you know that right now there are anywhere between ten to one hundred trillion microbial cells in your body right now? Even if you haven’t heard the word “microbe” before, you’re certainly familiar with them. Bacteria and viruses are two of the most common types of microbes. The “human microbiota” is the term used to describe all of these microbial cells in your body.
Of the many microbial cells living in your body, most of them are bacteria living in your gut, in your gut microbiota. While we typically associate bacteria with infections or danger, not all bacteria are bad. In fact, it’s super important for your gut health and overall health to have a diversity of “good” bacteria making up your gut microbiota, which encompasses your GI tract. This microbiota is crucial for your health, since your gut serves as a line of defense against external threats.
Dr. Joseph says the more different types of healthy bacteria you have in your gut, the better you’ll be able to fight disease, since they all play different roles. You can look at your gut microbiota as a military, which needs multiple branches to function optimally, since each branch has its own strengths and responsibilities, Dr. Joseph says. So, the more diversity in your gut military, the easier it will be to fend off threats. Therefore, when antibiotics wipe out some of your military, your defenses are down, and you may not be able to fight off illnesses as well, leading to more frequent illness.
Your microbiota should naturally be in a state of a healthy balance of “good” and “bad” bacteria. However, it's been proven that antibiotics can throw off this balance by reducing bacteria diversity, and killing off too much of the “good” bacteria. Not only that, but there may be an overgrowth of potentially dangerous bacteria that can make you sick.
With antibiotics messing with your gut, it’s no wonder that common side effects include stomach pain, nausea, and diarrhea. One extremely dangerous complication of taking antibiotics is developing a C. difficile infection, which can cause diarrhea so severe that it’s life-threatening.
It’s not just current antibiotic use that can affect your microbiota, however. Even if you took antibiotics much earlier in life as a child, the negative effects may linger. As a child, your body is still laying down the foundation for trillions of healthy bacteria, and if antibiotic overuse kills some of them off, it can be hard for those healthy bacteria to come back, says Dr. Joseph.
Studies show that early childhood antibiotic overuse can lead to not only decreased diversity of good bacteria in the gut, but also increased risk of developing:
- Immune deficiencies
- Inflammatory bowel disease (IBD) and ulcerative colitis
- Metabolic deficiencies
- Weight gain
When all is said and done, the effect that antibiotics have on your gut microbiota can cause both short- and long-term adverse effects that are risky to your overall health and well-being.
Impacts of Antibiotic Overuse on Antibiotic Resistance
Another major problem of antibiotic overuse is antibiotic resistance, which the World Health Organization has declared as one of the biggest threats to global health. While antibiotic resistance is something that can and does occur naturally on its own, the overuse of antibiotics in humans is greatly speeding this up.
This is a huge issue. There are about 2.8 million antibiotic-resistant infections every year in the United States. Sadly, this results in around 35,000 related deaths in the country annually. Even more alarming, it’s estimated that by the year 2050, there will be around 317,000 antibiotic-resistant infection-related deaths each year in the US.
Antibiotic resistance doesn’t mean that you as a human have become resistant to antibiotics. Rather, it means that the bacteria themselves have changed. Essentially, the bacteria evolve to outsmart the antibiotics. Instead of the antibiotics prevailing over the harmful bacteria, the bacteria prevail over the antibiotics. The result? Infections that become extremely tricky, or even impossible, to cure.
More and more infection-causing bacteria are developing antibiotic resistance, including:
- Strep throat
When antibiotics fail to treat bacterial infections, more treatment modalities become necessary. Second or third line treatments may be used –– but these have potential to cause severe harm, recovery that might last months or even organ failure.
Due to modern lifestyles, travel, and globalization, antibiotic-resistant bacteria can be transmitted far and wide, which is what makes this a truly world-wide health threat.
The Bottom Line about Antibiotic Overuse
Antibiotic overuse is potentially detrimental to both your individual health and public health on a global scale. Next time you’re sick, it’s important to listen to your doctor when they tell you that an antibiotic is not necessary in a specific case. You can’t turn back time and erase past episodes of antibiotic usage, but you can be an educated patient going forward and only take antibiotics when they are truly necessary to promote better health and safety for yourself and others.
When it comes down to it, antibiotic overuse contributes to many people feeling unwell, often not even knowing the root cause of the discomfort. A functional medicine root-cause approach takes a comprehensive look at every aspect of your health throughout the whole of your life, rather than just examining discrete parts of health and well-being in isolation, and can help you figure out how to address the imbalances in your unique gut microbiome.
If you’re ready to tackle the root cause of your illness, including antibiotic overuse, it’s time to get serious about your health and embark on the path toward making more positive changes.
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