It has been almost 80 years since antibiotics were first prescribed, and in that time humans have embraced these wonder drugs with gusto. There's no doubt that their effectiveness in treating bacterial infections has saved lives and revolutionised modern medicine, however, there is concern around our strong reliance on antibiotics.
With antibiotics commonly prescribed for viral infections, against which they're powerless, and overuse increasing the risk of antibiotic-resistant bacteria, moderation seems like a better course of action.
Instead, Australia has one of the highest rates of antibiotic use in the world, and by their first birthday, half of all Aussie babies will have received at least one course of antibiotics – with many exposed to the medicine while still in the womb.
Let's consider some research around the possible long-term effects of antibiotic exposure in early life and remind ourselves about the great power – and responsibility – that comes with a course of antibiotics.
Do antibiotics affect children's immune responses?
There has been some research suggesting that antibiotics impact our immune system, and this goes back to our gut response. Although antibiotics are used to fight 'bad bacteria,' humans also rely on good bacteria, viruses, fungi and other organisms for our health and wellbeing. These critters live in our gut and are called 'the microbiome'.
The microbiome plays a role in our mental and physical health throughout our lives, and in a baby's first weeks and months, it helps to develop their immune system. Babies are first exposed to the microbiome when they're born vaginally or come in contact with their mother's skin after a Caesarean.
However, there is concern that antibiotic use during pregnancy, especially close to delivery, can kill off good bacteria in the mother's microbiome, leaving her baby's immune system with a less balanced microbiome to learn from once they're born.
According to a Danish study, the flow-on effect is that, 'Antibiotic exposure before or during pregnancy [is] associated with increased risk of childhood hospitalised infections,' although other environmental and genetic factors may also play a role.
Are antibiotics linked with obesity?
Another possible effect of antibiotics relates to weight gain. Antibiotics are used to promote growth in livestock, and according to a New York University School of Medicine study, antibiotic exposure in the first year of human life is associated with a 10 to 15 per cent increased risk of obesity. There is also some evidence that taking antibiotics while pregnant may lead to a higher birth weight and obesity in early life.
However, do keep in mind that further research is needed in this area and other factors, including the timing and type of antibiotics, might contribute to weight gain.
Are antibiotics associated with childhood asthma?
Researchers have also noticed a parallel increase in the use of antibiotics and the prevalence of childhood asthma. Some studies have suggested that using antibiotics in pregnancy or prescribing them in early life may be associated with a child getting asthma later on, tied in with the idea of the imbalanced microbiome.
However, this association doesn't prove that antibiotics actually cause asthma, other factors are at play and more research is needed. In any event, a large-scale Swedish study found, 'Though antibiotics might not cause asthma, careful consideration is required as to whether respiratory symptoms should be treated with them.'
Can antibiotics increase the risk of gastrointestinal and inflammatory diseases?
Some connections have also been made between early antibiotics use (especially in the baby's first 12 months) and an increased risk of Crohn's disease, coeliac disease, or juvenile idiopathic arthritis.
However, again, antibiotics haven't been proven to cause these diseases, and the children might have been given antibiotics to treat their undiagnosed symptoms, rather than being prescribed antibiotics that led to their ill health.
What fears are there around the rise of antibiotic-resistant bacteria?
Something that medical professionals and governments are very concerned about is the prospect of a 'post-antibiotic era.' This is where many bacteria have become resistant to antibiotics, transforming common infections and minor injuries into huge health problems.
In fact, The World Health Organization describes antimicrobial resistance as, 'A problem so serious that it threatens the achievements of modern medicine.'
What can be done? According to a report in The Medical Journal of Australia it's important to:
Take a more restrained approach to antibiotic use and infection control, using antibiotics only when really necessary
Increase antibiotic research and development
Avoid eating foods that contain antimicrobial-resistant organisms, such as imported seafood and meat
The wrap-up of all this is that antibiotics are a truly marvellous medicine. However, to retain their potency and limit their possible long-term health affects, it's a good idea to ask your doctor for advice and alternatives, and to treat antibiotics with care.