"Our microbiome - the eco-system that includes all the bacteria, fungi and microbes that live within us and on our skin surface - serves to keep us healthy, safe and well-nourished. In this context, the responsible use of antibiotics has never been more important”.

Antibiotics have well-defined roles in preventing and treating serious or life-threatening infections. Go to a doctor’s office with a fever or a cough, and chances are you will be prescribed an antibiotic, despite over 90% of such illnesses being due to self-limiting viral syndromes that do not require antibiotics.

The challenge is discerning the early stages of a serious bacterial infection from a garden-variety viral illness. The former requires immediate institution of appropriate antibiotics; the latter calls for hydration, good nutrition, restful sleep, plenty of sunshine and the tincture of time. It takes an experienced and competent physician to distinguish the two - and even so, illnesses come with their own clever bag of tricks.

Antibiotic misuse is a global health crisis. The information gap between patients and doctors, the prevailing medico-legal landscape, patient expectations, as well as the relative ease of antibiotic prescription, create the necessary requisites for this crisis to propagate. Antibiotic use, especially in childhood, has short and long term repercussions. The medical literature is abundant with associations of childhood antibiotic use and obesity, depression, skin disorders, allergies, inflammatory bowel disease, and more.

“Our microbiome is an eco-system. Each of us have our own unique microbial composition - much like our unique fingerprints. We have as many - if not more - bacterial cells within us and on our skin surface as we do human cells. So why harm ourselves unnecessarily?”

If we keep using antibiotics the way we currently do - without sufficient regulation, stewardship, or a second thought - we run the risk of facilitating ‘superbugs’ for which no treatment exists. I have personally observed life-threatening bloodstream infections with multi-drug resistant bacteria that are resistant to each and every available antibiotic. The widespread use of antibiotics in agri-farming has significantly worsened the impact on our collective microbiomes.

Antibiotics are life-saving interventions. They must be used when and where indicated to avoid catastrophic consequences. However, health practices must not be based on fear: “If I don’t take / prescribe the antibiotic, things may get worse...I just want to be careful”. Rather, these practices must be scientific and evidence based: “Although the patient has a fever, runny nose and a cough, there are no warning signs or predictors of poor outcomes... watchful waiting and close follow-up is preferred over antibiotics at this point”.

So what can we do? Be mindful of antibiotic consumption. Pay attention to keeping your microbiome optimized and balanced, so you will reap immense health benefits. Find a healthcare provider who is willing to discuss the pros and cons of antibiotics. Ask if antibiotics are really necessary for a given infection, or whether watchful waiting is a safe option. Being an active participant in the management of your health, engaging positively with your healthcare providers, following their instructions closely and maintaining open channels of communication with your healthcare providers go a long way in ensuring a happy, healthy life.