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Microbes Fight Back: How Antibiotic Use Affects Our Microbiome?
The use of antibiotics is undoubtedly a revolutionary advancement in modern medicine, but its impact is far-reaching and complex. Since their invention in the 1940s, the widespread use of antibiotics has provided humans with powerful weapons in the fight against infection, but it has also brought about a series of problems, especially the problem of microbial resistance.
Every time an antibiotic is used, it exerts selective evolutionary pressure on the microbial community, which may lead to perturbation of its normal microbiome and the development of drug resistance.
The goal of Antimicrobial Stewardship (AMS) is to promote the optimal use of antibiotics, which encompasses not only drug selection, dosage and duration of treatment, but also route of administration. Since the 1990s, antimicrobial management has become an important matter promoted by infectious disease experts, the public health community and other fields. Its main purpose is to protect our microbiome by reducing unnecessary antibiotic use and reducing the risk of antibiotic resistance.
The use and impact of antibiotics
Antibiotic use affects our microbiome. According to some studies, whenever antibiotics are used, the structure of the normal microbiota is disrupted, a phenomenon known as "dysbiosis." Not only does this lead to the growth of pathogenic microorganisms, it may also reduce the number of healthy microorganisms, further increasing the risk of infection.
Rational antibiotic use strategies can not only improve patient health prognosis, but also effectively reduce the occurrence of antibiotic-related diseases.
History of Antimicrobial Stewardship
The problem of antibiotic abuse was raised as early as the 1940s. But it was not until the 1990s that the concept of antimicrobial stewardship gradually emerged. As the problem of drug resistance becomes increasingly serious, many countries have begun to pay attention to this issue and formulate corresponding management policies and guidelines.
For example, in the United States, the 2017 Joint Commission decision required every hospital to have an antimicrobial stewardship team. California and Missouri even introduced legislation in 2019 requiring the implementation of antimicrobial management plans.
Elements of antimicrobial stewardship
The core of antimicrobial management is to promote the rational use of antibiotics. This typically involves baseline assessments of healthcare facilities, education and professional training related to antibiotic use, and ongoing tracking and feedback on antibiotic use.
The most effective antimicrobial stewardship practices include providing ongoing education and feedback to promote updated knowledge and improved practice among health care workers.
Challenges of Antimicrobial Stewardship
Although antimicrobial stewardship has shown its potential to reduce resistance and improve patient outcomes, implementation challenges remain. Part of these challenges comes from medical staff's cognition and behavior regarding antibiotic use. How to effectively change these behaviors is an important topic in current research.
Future direction
Future antimicrobial management will pay more attention to the application of data analysis and information technology to support scientific decision-making. Furthermore, as understanding of the microbiome improves, more targeted antimicrobial management strategies will likely emerge.
The impact of antibiotic use on the microbiome has brought about profound thinking: Should we reflect on our medication behavior and seek a more balanced approach to protect our microbiome?
