The over-prescribing and over-consumption of antibiotics is a subject that has long troubled me. When I first went into clinical practice almost 30 years ago, I noticed even then a complete lack of responsibility from some GPs and their patients when it came to how antibiotics were being prescribed. Patients were coming to expect that when they walked into the surgery with a cough or cold, they could walk away with a prescription – for antibiotic medication that won’t even work on a virus, which applies to most cases of coughs and colds. It is the job of your immune system to fight these, not a prescription from your GP.
Three decades or so into my career, I now see how we are reaping what has been sown – the growing threat of antibiotic resistance. I found it staggering back then, as I do even more so now, that the ‘powers that be’ in the medical profession are still not warning people about the risks of taking too many antibiotics, although there are glimmers of hope. I went into my local GP surgery recently and spotted leaflets about the dangers of taking too many antibiotics, and I know that there are responsible GPs and gastroenterologists who do advise their patients to take a course of live bacteria probiotics following a course of antibiotics. But, is it too little too late?
The threat of antibiotic resistance was one of the primary reasons for developing my own range of digestive and gut health supplements. Did I want to take on all the stress, use my own pension money to set up the business, work 16-hour days, 7 days a week, for months and years, affecting my marriage and my health? I certainly did not, at least not at the age of 55, but I did; I couldn’t sit back, I had to do it. If you have knowledge about a certain thing and you know that by sharing that knowledge, you can help millions of people, you have to share it, don’t you?
How do things look now when it comes to prescribing antibiotics?
A study published in the British Medical Journal in 2019 puts some hard numbers on just how often antibiotics are over-prescribed. Nearly 25% of the time, antibiotics are inappropriately prescribed, the study finds.
The study also highlights how rampant over-prescribing and inappropriate prescribing of antibiotics still is, despite recent efforts to address the problem. Antibiotics are being commonly prescribed for conditions that aren’t even associated with a bacterial infection – like the common cold and flu, which are caused by viruses. On top of that, the animals we eat, unless certified organic, are typically given courses of antibiotics as well, to prevent disease in their crowded and dirty living conditions and to stimulate their growth. And let’s not forget about the wastewater from households, hospitals, and pharmaceutical companies which may carry antibiotics, deadly microbes, antibiotic resistance genes, and harsh chemicals and drugs. So even if we haven’t taken a prescribed course of antibiotics, we are still being exposed to them and ingesting them.
So what’s the harm in taking antibiotics? Aren’t we ‘better safe than sorry’? The answer is no – taking unnecessary antibiotics can actually do more harm than good. While antibiotics have saved millions of lives over the years, the excessive use and over-prescribing of these medications are wreaking havoc on your health because of their impact on your gut; and it’s not just the bacterial balance in your gut, antibiotics can also detrimentally affect the bacteria in your urinary system (think recurring UTIs), your lungs and on your skin. In fact, anywhere on and in your body that relies on beneficial bacteria to be healthy, antibiotics can decimate.
Antibiotics work by blocking vital processes in bacteria that either kill the bacteria or stop them from multiplying. Unfortunately, broad-spectrum antibiotics, the most commonly prescribed ones, cannot differentiate between the ‘bad’ bacteria that may be causing a bacterial infection and the ‘good’ bacteria that belong in your gut. Instead, antibiotics come through like a tsunami, destroying almost everything in their path, although it’s interesting that the more pathogenic strains of bacteria seem to withstand the onslaught of antibiotics, making them the dominant species in your gut when in actual fact, the dominant species should be the ‘good’ bugs.
When antibiotics kill the beneficial bacteria that belong in your gut, it disrupts the delicate ecosystem, creating a state of dysbiosis – or bacterial imbalance. As the number of good bacteria in your gut falls, you are left susceptible to developing digestive and gut problems, in particular IBS, painful trapped gas, uncomfortable bloating, constipation, diarrhoea, low-grade intestinal inflammation and ‘leaky’ gut, but not just that. Consider that around 70 – 80% of your immune system’s cells are produced in your gut and around 90% of your ‘happy’ hormone, the neuro-transmitter serotonin, is also produced in your gut. Little wonder that we also see an increase in auto-immune diseases and depression.
When are antibiotics needed?
Antibiotics are only needed for treating certain infections caused by bacteria. We rely on antibiotics to treat serious, life-threatening conditions such as pneumonia and sepsis, the body’s extreme response to an infection. Effective antibiotics are also needed for people who are at high risk for developing infections. Some of those at high risk for infections include patients undergoing surgery, patients with end-stage kidney disease, or patients receiving cancer therapy (chemotherapy).
When are antibiotics not needed?
Antibiotics do not work on viruses, such as those that cause colds, flu or runny noses, even if the mucus is thick, yellow, or green. Antibiotics are only needed for treating infections caused by bacteria, but even some bacterial infections get better without antibiotics. Antibiotics aren’t needed for many sinus infections and some ear infections.
Antibiotics save lives, and when a patient needs antibiotics, the benefits usually outweigh the risk of side effects and antibiotic resistance. When antibiotics aren’t needed, they won’t help you, and the side effects could still cause harm. Common side effects of antibiotics can include:
- rash
- nausea
- antibiotic-associated diarrhoea
- constipation
- stomach cramps
- bloating
- vomiting
- acid reflux
- yeast infections
More serious side effects include C. difficile infection, which causes severe diarrhoea and can lead to severe colon damage and death especially in the elderly. People can also have severe and life-threatening allergic reactions.
What you can do to feel better (without antibiotics)
Respiratory viruses usually go away in a week or two without treatment. Ask your healthcare professional about the best way to feel better and get relief from symptoms while your body fights off the virus. My recommendation, with the exception of taking live bacteria probiotics and an aged, high strength garlic tablet, is to take a good Vitamin C supplement with zinc, and the herbal tincture preparation, Echinacea. I’ve been recommending the aforementioned for the best part of 30 years to help alleviate inflammation, infections and to support a healthy immune system.
To stay healthy and keep others healthy:
- Wash your hands frequently in hot, soapy water for at least 20 seconds
- Cover coughs and sneezing. Think ‘catch it, bin it, kill it.’
- Stay home when sick
- Get plenty of rest. Don’t feel guilty about going to bed and sleeping. It really is the BEST medicine.
- Seek the advice of a nutritional therapist, a naturopath or a medical herbalist to stay healthy, particularly throughout the winter months, or visit your local independent health food shop, where they will be happy to make supplement recommendations to help you maintain a healthy and balanced immune system, making you more resilient and resistant to infections.
If you do have to take antibiotics, it is highly advisable to start taking live bacteria probiotics as soon as you have completed the course of medication, for a minimum of three months.
The antibiotics will have killed off the bacteria causing the infection, but in doing so, a large number of the good bacteria in your gut will also have been wiped out. It’s therefore vital to replenish the beneficial bacteria so your immune system can return to peak performance, and help prevent any further infections. A healthy balance of gut flora will also reduce the risk of developing both functional (IBS) and/or organic (IBD) problems.
In a 2019 white paper, prepared by the International Scientific Association for Probiotics and Prebiotics, evidence from a number of clinical trials to evaluate the safety and efficacy of different probiotics for several conditions, including antibiotic-associated diarrhea (AAD), showed that certain strains of friendly bacteria are able to reduce the risk of AAD – a common side effect of antibiotic treatment.
I am a firm believer in the importance of taking probiotics after a course of antibiotics, however, I’ve always had reservations about the taking of probiotics at the same time as antibiotics. For starters, the antibiotics may just wipe out all the probiotics, resulting in a waste of money, and there is always the risk that the probiotics may affect the efficacy of the antibiotics.
So for anyone who takes probiotics on a regular basis, I would always advise coming off them when taking a course of antibiotics, unless there is evidence of AAD, or a worsening of IBS symptoms, in which case, take the probiotics and antibiotics at least two hours apart. However, I would always advise the person to seek the advice of their GP because there are so many different antibiotics, some of them slow release, meaning taking probiotics at all during this time would be pointless.
My next blog post will delve deeper into antibiotic resistance, one of the biggest threats to our health today, and how we can better protect ourselves and our loved ones from succumbing to any number of diseases, that at one time would have been cured by antibiotics, but is now no longer the case.
We have our own inbuilt defender against being attacked by bugs and viruses – our immune system – and it is very important that you know how to take care of your immune system so that it is balanced and healthy. You may want to have a read of my immunity blog post here for more tips on how to get a strong immune system.