Increased antibiotic use is associated with an increased risk for hospitalization. The study looked at primary care medical records linked to hospital admissions in 1.8 million patients from 2000 to 2016, and analyzed those who had received systemic antibiotics. Infections of interest included urinary tract, ear, and respiratory (those with more serious chronic conditions like cystic fibrosis and chronic lung disease were excluded from the study).
The results showed that the more antibiotics a patient was prescribed, the more likely they were to be hospitalized for a subsequent infection in 3 or more months. Those with 9 or more antibiotic prescriptions were 2.26 times more likely to be hospitalized, while those with 5 to 8, 3 or 4, and 2 antibiotic prescriptions were 1.77, 1.33, and 1.23 more likely, respectively. BMC Medicine
Takeaway: Researchers who conducted the study claim that the overuse of antibiotics for common infections is “unproven – and possibly negative,” as the study findings illustrate. The study does have some weaknesses, including the inability for researchers to adjust for the possibility that some patients who are receiving excessive antibiotics could be immunocompromised, and would be at risk for multiple hospitalizations. Nonetheless, the detrimental effects antibiotics have on the gut microbiota are widely recognized; one course of a broad-spectrum antibiotic can wipe out up to a fifth of your gut bacteria, without the promise of ever achieving meaningful re-colonization. So, while low immunity could be part of the problem in some of these patients, excessive antibiotics may actually increase the risk of subsequent infections in these individuals and others.
The study’s scientists call for “antimicrobial stewardship” where doctors and patients alike recognize the harm of over-prescribing (and over-using) antibiotics, and commit to asking questions about why these medications are being prescribed in the first place, and if they’re truly necessary.
During the pandemic, more than ever, protecting your gut microbes is of utmost importance. If your doctor presents antibiotics as a treatment regimen for an infection, here are some important questions to ask:
- Is the antibiotic prescribed for me absolutely necessary?
- Is the antibiotic prescribed being used to treat an actual infection, or to prevent one?
- Do you have the results of the culture, swab, or biopsy back yet that demonstrate an infection, or are you treating me presumptively because you think the results will be positive?
- What other options are there for me to feel better besides an antibiotic?
- What would be the natural course of my illness if I didn‘t take an antibiotic?
- How long should it take for me to start feeling better if I don‘t take an antibiotic?
- If I do have to take an antibiotic, what‘s the shortest amount of time I can take it for?
- Is there a more narrow-spectrum antibiotic such as penicillin that would still be effective for my condition?
- If I decide not to take an antibiotic, what are the signs to watch for that might suggest that my condition is worsening and I might need to start an antibiotic?
- What‘s the worst thing that could happen if I don‘t take an antibiotic?
Looking for effective, safe, alternative methods to treat common infections may also be helpful. For step-by-step guides to treating UTI’s and upper respiratory infections, check out Dr. Chutkan’s book, The Microbiome Solution.