Last week we discussed the research pointing to a direct connection between the overuse of antibiotics and the increasing number of allergy sufferers nationwide. This week we will build on the topic with Part II of Avery August’s distinguished article, right where we left off last week.
Do more microbes means fewer allergies?
Research done in Europe has shown that children who grow up on farms have a wider diversity of microbes in their gut, and have up to 70% reduced prevalence of allergies and asthma compared to children who did not grow up on farms. This is because exposure to such a wide range of microbes allows our immune systems to undergo balanced maturation, thus providing protection against inappropriate immune responses.
In our attempts to prevent infections, we may be setting the stage for our children to developing life-threatening allergies and asthma.
For instance, a study from 2005 found that infants exposed to antibiotics in the first 4-6 months have a 1.3- to 5-fold higher risk of developing allergy. And infants with reduced bacterial diversity, which can occur with antibiotic use, have increased risk of developing eczema.
And it’s not the just the antibiotics kids take that can make a difference. It’s also the antibiotics their mothers take. The Copenhagen Prospective Study on Asthma in Childhood Cohort, a major longitudinal study of infants born to asthmatic mothers in Denmark, reported that children whose mothers took antibiotics during pregnancy were almost twice as likely to develop asthma compared to children whose mothers did not take antibiotics during pregnancy.
Finally, in mice studies, offspring of mice treated with antibiotics were shown to have an increased likelihood of developing allergies and asthma.
Why are antibiotics overused?
Physicians and patients know that overusing antibiotics can cause big problems. It seems that a relatively small number of physicians are driving overprescription of antibiotics. A recent study of physician prescribing practices reported that 10% of physicians prescribed antibiotics to 95% of their patients with upper respiratory tract infections.
Health care professionals should not only be concerned about the development of antibiotic resistance, but also the fact that we may be creating another health problem in our patients, and possibly in their children too.
Parents should think carefully about asking physicians for antibiotics in an attempt to treat their children’s common colds and sore throats (or their own), which are often caused by viral infections that don’t respond to them anyway. And doctors should think twice about prescribing antibiotics to treat these illnesses, too.
As we develop new antibiotics, we need to address overuse
As resistant bacteria become a greater problem, we desperately need to develop new antibiotics. The development process for a new antibiotic takes a considerable amount of time (up to 10 years), and drug companies have previously neglected this area of drug development.
Congress has recognized that antibiotic overuse is a major problem and recently passed the 21st Century Cures bill. This bill includes provisions that would create payment incentives from Medicare for hospitals that use new antibiotics.
But this approach would have the perverse effect of increasing the use of any new antibiotics in our arsenal without regard for whether bacterial resistance has developed. This would not only exacerbate the problem of resistance, but potentially lead to more people developing allergies.
Congress should consider more than just supporting increased development of new antibiotics, but also address the core problem of overuse. This may stave off the further development of antibiotic resistant bacteria and reduce the trend of increasing development of allergies.
Read the full article by Avery August, Professor of Immunology and Chair of the Department of Microbiology and Immunology, Cornell Universityy here.
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This article was originally published on The Conversation.
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