BOOK REVIEW: Missing Microbes by Martin J. Blaser, MD

Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern PlaguesMissing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues by Martin J. Blaser
My rating: 4 of 5 stars

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This is one of several popular human biology books of recent years to take note of the fact that your body’s cells are outnumbered 10 to 1 by the bacteria that live in and on you—mostly in your digestive tract—and that our penchant for killing microbes has begun to show signs of harm as well as good. Since the germ theory took hold, we’ve been slaughtering all the little buggers we could, but increasingly we’ve learned that this isn’t without costs. In essence, we’ve been throwing out the baby with the bath water when it comes to our bacteria, while at the same time creating super-bugs.

As a first-worlder who’s been living in the developing world (India), I sometimes get ask if I get sick here a lot or at all. My stock response is to ask the asker whether they have Crohn’s Disease, IBS, Type II diabetes*, or any of the other diseases of affluence seen mostly in the first world. (*Type II diabetes is becoming much more prevalent in the developing world, notably in India where they like their deserts about 9000 times sweeter than, say, a fudge brownie. Furthermore, the disease has disproportionate effects in such countries because of limited treatment availability and late diagnosis.) In many cases, these developed world diseases are being tied to the killing off of our good gut bacteria.

Doctor Blaser’s book focuses on how overuse of antibiotics creates problems. For those who say, “I don’t get no stinkin’ antibiotics when I’m sick. I just suffer it out. Ergo, I don’t need to read this book,” there remain facts of which you should be aware. One such fact is that some of the antibiotics injected into the animals that become our food can act against our own personal microbiome. Yet another is that antibacterial soaps and gels are ubiquitous. Furthermore, the increased popularity of C-sections has starved infants of a source of good bacteria, and made them more prone to certain childhood illnesses.

“Missing Microbes” is organized into 16 chapters. The first discusses many of the “modern plagues” that have come about through the wholesale war on bacteria. The next couple chapters look at the role of microbes on the planet and in our bodies. There is a discussion of increasingly successful pathogens as well as the drugs that came along to take care of them. There is a discussion of over-prescription of antibiotics by dentists and doctors, their use in agriculture, and the transfer of good bacteria from mother to child and how rampant use of C-section negates this transfer. There are a couple of chapters on H. pylori and the lessons learned from trying to eliminate it after it became tied to ulcers. (In one of the most famous stories in modern medicine, a researcher swallowed a beaker of H. pylori to prove his theory to a skeptical audience of physicians.) Asthma is discussed as an example of an illness one might not expect to come about from destroying gut bacteria. One of the effects covered over two chapters is getting bigger (re: fatter as well as taller.) Staving off disease under crowded conditions isn’t the only reason modern agriculture uses antibiotics, it also makes for big, meaty animals—which when eaten by people may make big, meaty (actually, fatty) humans. Blaser then talks about how bad the situation might get (using the term “antibiotic winter,”) before discussing solutions. It’s, of course, true that humanity has gained a lot from antibiotics, and so putting the genie back in the bottle is not a solution. A nuanced approach is called for, and that’s what the author discusses.

I found this book to be informative, and would recommend it to anyone wanting to learn more about the risks presented by overuse of antibiotics.

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