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Gastroenterology

The Janus face of Antibiotics: Life Savers & Microbiota Disrupters

Drug
Dermatology Pulmonology Pediatrics Otorhinolaryngology Gastroenterology

A page turns: with the advent of antibiotics in the 20th century, this type of therapy, despite its undoubted usefulness in fighting infections, now raises serious concerns for health, notably with microbiota dysbiosis and antibiotic resistance.

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About this article

Created 17 November 2020
Updated 07 January 2022

Introduction

Though a more rational use of antibiotics has long been overdue, we must not lose sight of the fact that over the course of the last 80 years their widespread use has saved many millions of lives. They have served as our principal weapon in the fight against bacterial infections. Alongside vaccinations, they have added around 20 years to the average life.1

18 out of 1,000

"18 out of 1,000 people take antibiotics every day.”5

FROM THE ANTIBIOTIC ERA TO THE MICROBIOTA ERA

Unfortunately, antibiotics eliminate not only pathogenic bacteria, but commensal ones too.2 The intestinal microbiota is affected, and likewise all the other human microbiota (cutaneous, lung, urogenital...) that protect against pathogen overgrowth. While it remains difficult to define a healthy microbiota with any precision or to provide an adequate description of dysbiosis, science is beginning to understand the ways in which antibiotics affect the functioning of these ecosystems and likewise the consequences of such changes for health over the short and long term3 (See Figure 1).

Dysbiosis

"Dysbiosis" is not a homogenous phenomenon: it varies according to the state of health of each individual. It is commonly defined as a compositional and functional alteration in the microbiota, driven by a set of environmental and host-related factors that perturb the microbial ecosystem.4

ANTIMICROBIAL RESISTANCE, A GLOBAL PUBLIC HEALTH PROBLEM

Because of the widespread overuse and misuse of antibiotics in humans and animals, bacteria causing both benign and life-threatening infections are becoming increasingly resistant to them. In 2015, antibiotic-resistant pathogens were estimated to be causing over 50,000 deaths each year in Europe and the United States.3 “Antibiotic resistance is one of the biggest threats to global health, food security and development today” states the WHO.

Image
Sources

1 WHO https://www.euro.who.int/en/media-centre/sections/press-releases/2012/11/self-prescription-of-antibiotics-boosts-superbugs-epidemic-in-the-european-region/antibiotic-resistance

2 Blaser MJ. Antibiotic use and its consequences for the normal microbiome. Science. 2016;352(6285):544-545.

3 Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med. 2016;8(1):39.

4 Levy M, Kolodziejczyk AA, Thaiss CA, et al. Dysbiosis and the immune system. Nat Rev Immunol. 2017;17(4):219-232.

5 World Health Organization. WHO report on surveillance of antibiotic consumption: 2016-2018 early implementation. Geneva; 2018.

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Otitis Atopic dermatitis Asthma Probiotics AAD C Difficile

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    Focus
    The Janus face of Antibiotics: Life Savers & Microbiota Disrupters
    • Introduction
      • The Janus face of Antibiotics: Life Savers & Microbiota Disrupters
    • Gut
      • From diarrhea to chronic diseases: the well-documented consequences of antibiotic-related gut microbiota dysbiosis
    • Urogenital
      • Urogenital microbiota: the spectrum of mycosis or urinary tract infections after each antibiotic treatment
    • Cutaneous
      • Antibiotics, a double-edged sword when managing skin disease
    • ENT
      • Ears, Nose and Throat microbiota: when antibiotics challenge our first line of defense
    • Lung
      • Antibiotic resistance: the lung microbiota pays a heavy price
    • Conclusion
      • What to take away?
    Created 17 November 2020
    Updated 07 January 2022

    About this article

    To know more about this topic.

    Main topic

    Drug

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    Dermatology Pulmonology Pediatrics Otorhinolaryngology Gastroenterology

    Content type

    Dossier detail
    The Janus face of Antibiotics: Life Savers & Microbiota Disrupters
    From diarrhea to chronic diseases: the well-documented consequences of antibiotic-related gut microbiota dysbiosis
    Focus

    The Janus face of Antibiotics: Life Savers & Microbiota Disrupters

    Introduction

    The Janus face of Antibiotics: Life Savers & Microbiota Disrupters

    Gut

    From diarrhea to chronic diseases: the well-documented consequences of antibiotic-related gut microbiota dysbiosis

    Urogenital

    Urogenital microbiota: the spectrum of mycosis or urinary tract infections after each antibiotic treatment

    Cutaneous

    Antibiotics, a double-edged sword when managing skin disease

    ENT

    Ears, Nose and Throat microbiota: when antibiotics challenge our first line of defense

    Lung

    Antibiotic resistance: the lung microbiota pays a heavy price

    Conclusion

    What to take away?

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