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Antibiotics 101

by Kelsey Asplin, ND in gut health February 25, 2020

Let’s clear the air on antibiotics.

The CDC reports that antibiotics are over prescribed and improperly given in over 50% of cases. However, antibiotics also turned the tide of human disease and continue to provide respectable benefits when appropriately used.

As a Naturopathic Doctor, antibiotics are rarely a first line treatment, but they can be very useful in cases of SIBO and are a reasonable backup consideration if natural therapies aren’t able to quickly manage conditions like UTIs, URIs, and skin infections.

It is actually VERY important to take antibiotics for the FULL course if you do decide to use them. This increases the likelihood that all the problematic bacteria will be wiped out, which is important because if there’s some left behind, it can adapt to become resistant to the antibiotic that was just used. Bacteria are very smart this way, and this scenario leads to antibiotic resistance almost as much as overprescribing does.

Antibiotics are non-discriminant. This means that they will wipe out any susceptible bacteria they come into contact with, both bad and good. This is what causes people to have GI symptoms like gas, bloating, diarrhea, etc. So it’s really important when using antibiotics to also use the right kind of probiotic to help maintain a healthy gut flora. If you don’t use a probiotic during or after antibiotic use, the house is empty and fair game for whomever wants to come squat or start a party – remember that analogy from before? If not, check out the earlier posts in this series. That is actually why you can have an increased likelihood of getting another infection after antibiotics – if the wrong bacteria set up shop, you may have a yeasty-beast or worse on your hands.

A specific strain of probiotics, called Saccharomyces boulardii, is the only probiotic not susceptible to antibiotics, so it’s awesome at preserving gut integrity and reestablishing some healthy gut flora following antibiotic use.

It’s also worth noting that antibiotics do effect your metabolism of other medications, like birth control. Make sure to check for interactions or ask your prescribing provider to make sure you’re covered, or you may find yourself with a miniature human within the next year.

Some classes of antibiotics carry more risks than others. Fluoroquinolones, for example, carry a black box warning from the FDA that they may cause “disabling and potentially permanent side effects” including, mental health and central nervous system side effects, blood sugar disturbances, tendonitis and tendon rupture, irreversible peripheral neuropathy, and possibly permanent other musculoskeletal problems. For these reason, fluoroquinolones should only be reserved for very serious bacterial conditions where other treatment options would likely be ineffective and where the benefit outweighs the risk.

What do you think about antibiotics? Have they come to your rescue before? What have your experiences been?