Antibiotic use and the microbiome

In the video above, Jill Maddison, Professor of general practice at the Royal Veterinary College, discusses the importance of antimicrobial stewardship.

In step 1.3, the importance of AMS was discussed on an individual level, and in step 1.4 it was discussed on a more global level. This step looks at AMS on a microscopic level, within the context of the microbiome.

The goal of antibacterial therapy is to help the body eliminate infectious organisms without toxicity to the host. This is most effective when it assists the natural defence mechanisms rather than acting as the sole mechanism of defence.

The natural defence mechanisms in the body include the gut normal flora and the skin normal flora. This is the combination of resident bacteria that are always present, and it is called the microbiome.

The microbiome plays a huge role in development and maturation of the immune system. The body creates tools so that the immune system and the microbiome can co-habit, and the microbiome can be kept under control. If there is a loss of control of the microbiome due to reduced diversity, loss of beneficial microbes or an increased number of pathogenic bacteria, dysbiosis occurs.

Antibiotics can have a significant or long-lasting effect on the microbiome.

There is currently a belief that the appropriate and responsible use of antibiotics will not aid AMR, and while this may be true at the site of infection, resistance will always occur to some degree in the normal flora. For appropriate use, this can be justified, as the antibiotics bring other benefits, however inappropriate use of antibiotics brings no benefits.

The article in the see also section provides further reading on this topic, and the effect that antibiotics can have on your microbiome.

Please find a downloadable copy of the PowerPoint slides used in the video in the downloads section below.