Have you ever looked around at something you take for granted like electricity or running water and imagined life without it? If not, you should try it some time. It’s a fantastic exercise in gratitude, and also an excellent way to become a doomsday prepper. If you fall down that rabbit hole, you’ll probably start trying to stockpile medical supplies, especially those used for the treatment of infection. But before you start filling your walls with old bottles of penicillin, you may first want to consider whether or not it will even be effective when the time comes and how you can ensure that it is. Which brings me to one of my very favorite soap boxes: overuse of antibiotics.

I know what you’re thinking – why would you talk about antibiotics on a regenerative medicine blog? My friend, let me count the reasons. First of all, you and I, and every other human being on this planet, are disgusting cesspool like petri dishes, teeming with thousands if not millions of strains of bacteria, all of which are poised to cause us big problems if we get a cut in the wrong place or find ourselves with a compromised immune system. Fortunately, wonderful antibiotics like penicillin, amoxicillin, and azithromycin are a simple prescription away. I credit these little molecules with keeping me alive when I had mononucleosis and a bacterial infection simultaneously as a second grader. In fact, I can think of instances when every person in my family has been saved by antibiotics, and what’s hilarious is that we don’t see that as a miracle anymore. But it is. One of the many reasons we enjoy the best life expectancy in the history of the human race is the existence and availability of antibiotics.

But as with many powerful tools, we the members of the human race, found a way to prove that there really can be too much of a good thing. But why? Because we fundamentally misunderstood the role of bacteria in the world. We believed it was black and white: bacteria bad, antibiotics good. Have a problem with bacteria? Throw antibiotics at it. Just think about the way parents explain handwashing to their kids. My mom was a big fan of saying our hands were covered in “yucky germs,” and she made the face that you found on the poison control stickers – the Mr. Yuk face. This lead me, and probably most people, to believe that all bacteria were bad from a very young age.

But the truth of the matter is – bacteria aren’t all bad. In fact, bacteria are a necessary component of human physiology, and when we nuke them out of our bodies with no consideration given to the ones we might need, we create other problems. People often get yeast infections after being treated with antibiotics, because the void left by all the dead bacteria is filled by another microorganism that was previously kept in check by the bacteria. The other thing that happens when we treat with antibiotics is pretty simple: we kill the bacteria that we can. Let me explain. Bacteria, like people, are not all exactly the same. Some of them are born with immunity to certain antibiotics. If some of those resistant bacteria are hanging around when you’re treated with antibiotics, something horrifying happens. We kill everything off, except those few resistant little bugs. And we leave a giant void, a nice warm home, and lots of free food to help them thrive. Which means that suddenly you have a very serious problem with antibiotic resistant bacteria.

In many cases, we can just treat with another antibiotic, and everything is fine. The problem we’re currently experiencing is that multi-drug resistant bacteria are becoming more and more common. So we’re running out of effective antibiotics, and in the meantime we’re creating perfect environments for these multi-drug resistant strains of bacteria to thrive and achieve their dreams of world domination. Mercifully, the powers that be are noticing that our overuse of antibiotic compounds is becoming a very scary problem, and they’re taking steps to curb that. My personal opinion is that the FDA should have taken their recent steps years ago, but I also believe each one of us needs to do as much as we can to minimize our personal effect on the rising tide of antibiotic resistance.

How do we do that?

  • Wash your hands with regular soap.
    I’ve been living with regular, non-antibacterial soap in my house for years and haven’t died of a bacterial infection yet.
  • When you have a sniffle, don’t take a Z-pack, and especially don’t request antibiotics when you don’t know if you have a bacterial or viral infection.
    Pro Tip: antibiotics do not work on viral infections, but they will create an imbalance in your natural bacterial flora if you take them unnecessarily.
  • If you do take antibiotics for a confirmed bacterial infection, FINISH YOUR PRESCRIPTION.
    This ensures that the antibiotic susceptible bacteria are killed by your pills, and that your body has the bandwidth to knock out any resistant bacteria on its own.
  • If you’re a clinician, explore other ways you can treat or prevent infection.
    This is where we tie into regenerative medicine, and where people are probably going to take issue with what I’m saying.

Please remember, I am not a medical doctor, and I’m not giving medical advice. I am a scientist and a concerned citizen of the world who would like to point out some relevant information. A recently published study demonstrated the treatment of infected non-union fractures with bone marrow concentrate and NOT antibiotics. Yes, you read that right. Antibiotics were withheld from patients with confirmed bacterial infections in their bones, their own bone marrow derived cells were used to treat instead, and it worked. Rather than create a global bacterial imbalance in these patients, their surgeon chose to treat locally with the body’s own immune and progenitor cells, whose infection targeting skills are multi-faceted, unlike antibiotics, which really are one trick ponies. I think when we see more clinicians using this type of approach for treatment of infection, we will see a decrease in antibiotic resistant bacteria. One more note: I’m not saying that antibiotics are bad. I am saying that they are not the only tools in our box, and we all need to do our best to only use them when necessary and to use them correctly so that they remain effective when we need them. And I’m also plugging some outside the box thinking. The immune system is an elegant creature, and if we as a society can find more ways to boost it and allow it to take care of infection when we can, I think we all win.