Dr. Joseph Sirven: Are We Overprescribing Antibiotics?
“Dr. Sirven, would you mind writing a prescription for antibiotics?” asked a patient.
“Oh, I don’t feel comfortable doing that unless I’m certain you really need them,” I said.
The patient jokingly followed with, “Oh, come on, did you miss that day in med school? I have a runny nose and a cough, and an antibiotic would easily take care of it.”
I gently counter with, “It really may not. Let’s swab that throat to make sure you need it.”
Antibiotic requests are common for doctors. In addition to antibiotic resistance, there may be an even bigger reason why we should not be overprescribing antibiotics and that has to do with the bacteria that live on your body — collectively known as the human microbiome. That's the word used to describe the collection of the microorganisms living with the human body. These germ communities consist of a variety of microorganisms including fungi and bacteria.
These bugs number 10 times more than human cells, yet account for only 1 to 3 pounds of our body weight. Not only are these microbes not harmful to us, they are essential to our health. Thus, needless antibiotics can hurt our friendly bugs. And yet how much these tiny organisms contribute to disease is unknown.
To answer that question, the National Institutes of Health created a large study entitled The Human Microbiome Project*. Research is happening in an area called microbiomics and it may upend the future practice of medicine. For example, microbes contribute more genes responsible for human survival than our own genes. Some microbiomes perform vital human functions such as producing vitamins, breaking down food for nutrients and teaching our immune system which bugs to fight. Even more important, changes in this composition might correlate with diseases like dental cavities, skin reactions and Crohn’s disease.
So when you call your doctor for antibiotics, you might get a prescription for helpful bacteria instead of the anti-bacteria. The new way might be probiotics to help determine our health.
Dr. Sirven is the chairman of neurology at the Mayo Clinic.