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Antibiotics and Immunity: Adverse Effects On The Immune System

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The practice of prescribing antibiotics has been a hotly debated and highly controversial topic for decades. The Centers for Disease Control and Prevention (CDC) suggests that 50% of antibiotics prescribed in the outpatient setting are unnecessary or inappropriate [1].  

The context whereby a substance is used will determine whether it is harmful or advantageous. Marijuana is beneficial when used in the right medical treatments but can lead to devastating consequences and even fatality when abused and misused. 

Antibiotics And Immunity: Dos And Don’ts And Side Effects 

Similarly, antibiotics are a fundamental part of treating and curing certain infectious diseases and play a critical role in saving lives. However, when utilized in the wrong context or prescribed carelessly, antibiotics may lead to terrible adverse effects and, occasionally, irreversible implications to an individual's immunity. 

What Are Antibiotics? 

Antibiotics are medications that treat or cure bacterial and some parasitic infections, but not viral or fungal infections [2].  

Some classes of antibiotics are tetracyclines, fluoroquinolones, penicillins, macrolides, cephalosporins, and lincosamides [3]. Each class of antibiotics harnesses different mechanisms to either cease the multiplication of harmful bacteria or kill bacteria by destroying their cell wall [2].  

How Are Antibiotics Prescribed?  

Healthcare professionals prescribe them to treat bacterial infections. Antibiotics come in either oral liquid or tablet form for oral use. Some are administered intravenously for severe inpatient cases where patients may be hemodynamically unstable. For skin-related infections and diseases, topical antibiotics in creams, lotions, or sprays are utilized.  

When prescribing antibiotics to patients, physicians take into account several factors to ensure safety and efficacy. This includes the type of infection, the correct dose and timing, the most suitable route of administration, the duration of antibiotic use, and the possibility of allergic reactions or adverse effects [4].  


How Do Antibiotics Affect The Immune System?  

Gut microbiota refers to the microorganisms, inclusive of bacteria that live in your intestines. Some of these naturally occurring microorganisms and bacteria can influence the functionality and responses of your immune system [5]. They can influence your immune responses by training and inducing your immune system to fight off diseases, pathogenic organisms, and infections [6].  

When antibiotics are unnecessarily or incorrectly used, they can alter the balance of the naturally occurring bacteria in your digestive tract by killing or halting the multiplication of certain bacteria. Since the balance of bacteria in your gut is associated with how your immune system responds, antibiotics can make your body more susceptible to infections and diseases [5].  

Each antibiotic class may produce a different effect on the commensal community in the gut. For example, researchers discovered in a study that oral ciprofloxacin treatment influences approximately one-third of the microbiota in the intestines, leading to a disruption in the balance, richness, diversity, and composition of the commensal population [7].  

Antibiotics and Immunity

Besides that, a study involving oral clindamycin showed that a short-term course of clindamycin could alter the ecological stability and diversity of the Bacteroides genus. This effect can last up to 2 years after treatment cessation [8].  

Because the beneficial members of the gut microbiota can hinder infections by preventing the expansion of pathogenic organisms in your digestive tract, any alteration in the normal balance will allow pathogens to multiply and inflict harm onto the host. This alteration is associated with medical conditions such as infections, diabetes, obesity, atherosclerosis, and inflammatory bowel syndrome (IBD) [9].  

A study involving animal models also suggested the influence antibiotic treatment has over your susceptibility to allergic diseases. Antibiotic intake depletes specific bacterial communities in the intestines. This depletion and deletion of those populations are associated with heightened serum IgE levels, elevated circulating basophils, and exaggerated inflammatory allergic responses [10].  

Conclusively, inappropriate intake of oral antibiotics can cause the body to be more susceptible to viral and bacterial infections and other conditions such as allergies [5].   

Side Effects And Concerns Of Antibiotic Use 

The most frequently observed side effects from antibiotics revolve around the digestive system. They are so common that approximately 1 in 10 people will experience those kinds of side effects. Some of these adverse effects include nausea and vomiting, bloating and indigestion, diarrhea, abdominal pain, and loss of appetite [11].  

Another concern with antibiotic use is the development of an allergic reaction. Localized and mild rashes are mild allergic reactions that may develop post-antibiotic use. However, there is also the possibility of more severe and possibly life-threatening reactions such as anaphylaxis or tightening of the throat that makes breathing difficult [11].  

Antibiotics and Immunity

If you are currently on a course of antibiotics and experience any adverse effects that get worrying, stop the antibiotic course and seek medical attention immediately.  

Another significant concern currently with antibiotic use is the development of antibiotic resistance. This refers to resistance acquired by certain pathogenic bacteria that were initially susceptible to the antimicrobial compound. The antibiotic used to treat the diseases caused by that strain of bacteria is no longer effective. Because the bacteria have adapted via specific mechanisms that allow them to survive when facing environmental threats, they can circumvent the antibiotic attack [12].  

Multidrug-resistant organisms have become common. Originally-utilized antibiotic treatment courses can no longer eradicate infections caused by resistant pathogens, and this problem is worsened by the shortage of research and development of antibiotics [12].  

Dos And Don'ts Of Antibiotic Use 

Antibiotics are powerful treatment options to cure infections that could take your life. There are a few ways you can use antibiotics wisely. 

The next time your physician prescribes you a course of antibiotics, feel free to ask if there are other methods to clear the infection without using antibiotics [13]. Besides that, never request antibiotics from your doctor if you have a viral infection such as a cold or flu.  

Antibiotics and Immunity

Follow the instructions on how to take the antibiotics exactly and never skip a dose or cease the treatment without completing the entire course. Saving half-finished antibiotic courses for future infections will bring more harm than good. Thus, you should never self-medicate at home with leftover antibiotics or leave a few pills for future use [13].   


Antibiotics And Immunity: Summing Up  

First discovered in 1928, antibiotics currently stand as one of the most valuable and vital inventions in the medical field.  

Since antibiotics can weaken your immune system by altering the normal balance of bacteria in your gut, they should be used only when the benefits outweigh the risks. Furthermore, the antibiotic dosing regime must be optimized to minimize the possibility of harm to the patient or the development of antibiotic resistance.  

Everyone must ensure that these precious resources are protected. This will safeguard the efficacy and potency of antibiotics in eradicating life-threatening and severe infections for decades to come.   

References:

[1] https://www.cdc.gov/antibiotic-use/data/outpatient-prescribing/index.html 
[2] https://www.nhs.uk/conditions/antibiotics/ 
[3] https://arpsp.cdc.gov/profile/antibiotic-use/all-classes 
[4] https://www.nhs.uk/conditions/antibiotics/considerations/ 
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3427468/ 
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056765/ 
[7] https://pubmed.ncbi.nlm.nih.gov/19018661/ 
[8] https://www.nature.com/articles/ismej20073 
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885777/ 
[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321082/ 
[11] https://www.nhs.uk/conditions/antibiotics/side-effects/ 
[12] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888801/ 
[13] https://medlineplus.gov/ency/patientinstructions/000959.htm 

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