The Problems with Antibiotics: Antibiotic Resistance

Allow me to preface this post series with a wholehearted acknowledgment of the beneficial role antibiotics have played, and continue to play, in fighting infections that might otherwise take limbs or lives. Before formal antibiotics, ancient and traditional cultures employed antibacterial herbs, tinctures, and even moldy bread, but regardless of the various methods’ efficacies, they were largely operating in the dark. They knew what worked, but not why it worked. When we use antibiotics today, we (mostly) understand what they are doing on a micro level, and we aren’t (ideally) just relying on hearsay, anecdote, and experimentation. This is a good thing.

So, how do antibiotics work, exactly? There are four primary routes taken by various antibiotics:

By crippling the microbe’s ability to fortify its cellular walls against external forces. Some antibiotics, like penicillin, prevent the target bacterium from manufacturing a substance called peptidoglycan that only bacteria use to construct cellular walls. Because animals don’t use peptidoglycan nor do our cells have “cell walls,” antibiotics don’t hurt our native cellular structures. Human tears actually contain lysozymes that also break apart peptidoglycan bonds in bacterial cell walls, much like antibiotics.

By binding to the protein synthesizing equipment inside the bacteria, gumming it up and interfering with its ability to arrange amino acids into proteins that perform vital roles. Tetracycline, a common antibiotic, binds to cellular ribosomes and interrupts an important step in RNA protein-sequencing. Luckily for us, human ribosomes don’t accumulate enough tetracycline to interrupt the sequence; bacterial ribosomes, however, accumulate enough to stop it altogether.

By preventing the bacteria’s synthesis of folic acid. Since all cells require folic acid and bacteria cannot absorb it from the environment, they must create their own. If something prevents its synthesis, the bacteria die. The sulfonamide class of antibiotics closely resembles para aminobenzoic acid, a critical component of the folic acid synthesis cycle. When bacteria mistake the sulfonamide for para aminobenzoic acid, they attempt to use the former to make folic acid. This doesn’t work and the bacteria eventually dies. Pretty devious, eh?

By targeting and interrupting the DNA replication process specific to bacteria. If a cell – any cell – is prevented from replicating its DNA, it dies. Ciprofloxacin is one antibiotic that targets DNA replication.

So, we’ve developed antibiotics that hit processes specific to bacterial cells while sparing human cells, and antibiotics that perform specific tasks and target specific species of bacteria. It all sounds pretty ironclad, yeah? There are some problems with antibiotics, though. Some very serious ones.

Foremost among them (at least in popular medical literature) is antibiotic resistance.

To understand antibiotic resistance, we must understand where most antibiotics come from. We derive pharmaceutical antibiotics from naturally-occurring bacterial weaponry, “natural” antibiotics manufactured and wielded by fungi, bacteria, and algae with the necessary genes in their ceaseless battle against other fungi, bacteria, and algae. Natural antibiotics and the bacteria the antibiotics are targeting have co-evolved over millions of years together. Just as the gazelle responds to the lion, and the lion to the gazelle, these microbes have also developed genetic counter-measures to enemy antibiotics. Written within their very genes are the tools to both produce and resist enemy antibiotics, and at least as far back as 30,000 years ago (and almost certainly many millions of years more, or for as long as bacteria have been battling each other), bacteria possessed the genes for antibiotic resistance. It’s been a lethal, ceaseless game of tit-for-tat against the backdrop of natural selection, with each side keeping the other in check.

Once we stepped in and began reproducing these antibiotics en masse, however, the delicate balance was tipped. Infectious diseases were hit pretty hard, and everyone hailed the great success of antibiotics. And they were a success, for the most part. The problem was the bacteria they were targeting kept evolving new defenses. And whereas “in the wild,” natural selection would usually produce a counter-counter-measure to the counter-measure and so on and so forth, we didn’t have that luxury. Our antibiotic pills weren’t going to adapt on their own. There was no selective force. We couldn’t just wait around for evolution to occur; we had to chemically alter the antibiotics to overcome the bacterial resistance. We had to laboriously and paintstakingly guide the hand of evolution ourselves. We had to engineer a selective force.

And so you have antibiotics like methicillin, which scientists created by modifying penicillin to get around bacterial resistance to penicillin. It worked, but only until bacteria like methicillin-resistant Stapphylococcus aureus (MRSA) emerged, and we had to start all over. Numerous other examples of resistant bacteria have surfaced as well:

  • The infamous Clostridium difficile, commonly known as C. diff.
  • Salmonella.
  • E. coli.
  • Certain species of Streptococcus.
  • Certain species of Enterococcus.
  • Certain strains of Mycobacterium tuberculosis.

Even those bacteria that do not endogenously possess the genes for antibiotic resistance can become resistant to antibiotics through a process called horizontal gene transfer, or HGT. HGT allows helpless bacteria to acquire genetic material from resistant bacteria that happen to be passing by. Through HGT, bacteria of one species can obtain antibiotic resistance from bacteria of another unrelated species. Acinetobacter baumannii, also known as multi-drug resistant acinebacter, is a common pathogen that obtained most of its resistances through HGT. In its cells, A. baumannii maintains multiple collections of foreign genetic material, kind of like a collector of weaponry from across the world. Oftentimes, the primary source of all this prime genetic material is a species of bacteria that poses no threat to humans but that wants to survive antibiotics just the same – and so develops numerous resistances which other, more dangerous species can pick up for free.

The big problem is that antibiotic resistance is a built-in feature of bacteria. It’s not going away. I mean, that’s what life does – it survives. And when the going gets tougher (when an organism is repeatedly subject to threats to its survival), that organism adapts and evolves and grows stronger. The more you produce the threat, the more you overprescribe antibiotics, the more you indiscriminately feed livestock antibiotics to promote faster growth, the quicker these resistances develop and spread.

Antibiotic resistance is a systemic issue, one that affects the global picture of health. It’s no doubt important, but there’s not a whole lot to do besides be aware of the issue (unless you’re a hotshot microbiologist actually working on new and improved antibiotics). There’s another problem with antibiotic usage, though, a hyper-local one that does impact us on an individual level and that we can hopefully successfully navigate. Next time, I’ll discuss that other unintended, but totally foreseeable, consequence of administering antibiotics in order to kill bacteria: the death of helpful bacteria living in the gut. And later, maybe in the same article if there’s enough time, I’ll go over strategies to combat the problems of antibiotics.

Thanks for reading this first part, and take care until next time. Let me know your thoughts in the comment section.

TAGS:  Big Pharma

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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115 thoughts on “The Problems with Antibiotics: Antibiotic Resistance”

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  1. We’re often told to complete(not dropout) the prescribed course of anti-biotics, is that related to the above post in anyway ? Does that give the microbes an advantage ?

    1. Oh yeah. The reason to complete a prescription is to kill ALL of the problem bacteria. Let’s say this takes 10 days. You take the prescription, and after seven days, you feel great, because you’ve killed of 99.9% of the problem bacteria. So you don’t complete the presciption. But what about the 00.1%? It is the strongest and most anti-biotic resistant. When it reproduces, you now have a more drug resistant strain of bacteria.

      1. Im currently on antibiotics for a nasty sinus infection. I was pretty resistant to this and tried numerous things to help- neti pot, humidifier, hit cold packs. Did all that for a week and a half. My kids got sick and so did my husband so I haven’t gotten nearly enough rest either, anyway, you got any natural sinus remedies?? I’m dying here

        1. i used to get horrible sinus infections, but conquered them with about three courses of a combination of echinacea and goldenseal tinctures, plus salt and tea-tree oil in my neti pot. GOOD LUCK! …do you live in a constantly-warm climate? i’m sure that leaving Gulf-coast TX helped in my case….

        2. I got a sinus infection while breastfeeding and my Dr put me on Sinupret forte, from a company called Bionorica, and Soledum from Casella Med. I have no idea if you can get those in the US, but they’re herbal pills (pkg warns they contain glucose, lactose, sacchrose and sorbitol) and did the trick, albeit slower than doxy would’ve.
          Old Oma trick: try a warm onion compress. Peel and finely chop an onion, heat in a pan without oil, pressing slightly with the back of a spoon to get the juices going, then spoon onto cheesecloth or a linen towel, fold into a package and lay over the infected site. Leave it on for as long as possible. This also works well for children’s ear infections BTW.
          Good luck, HTH

        3. You can help your body fight off infections (and give antibiotics you do have to take a helping hand) with coconut oil. Once in the body, the Lauric acid in coconut oil is converted to monolaurin, which has antibiotic, antiviral, and antifungal properties, if I’m not mistaken. (source: Mary Enig, “Know Your Fats” and “Eat Fat, Lose Fat.”) And coconut oil has a lot of Lauric acid in it–almost as much as mother’s milk. When I’m sick, I fix up a batch of coconut ginger soup and have some often. It’s delicious and a great way to up the coconut oil going in. Simmer equal parts of chicken broth and coconut milk with a few slices of fresh ginger for about 10 minutes. Enjoy.

        4. Have you tried nasal irrigation? Google “nasal irrigation” for information an demos. An inexpensive, reusable kit can be purchased at your pharmacy.

          As Mark says, it is essential you complete the prescribed course of antibiotics but irrigation may help relieve the symptoms.

        5. Thank you so much for the help. I am trying the tea tree oil and golden seal echanasia my ND had mentioned it to me too but I had my husband pick it up today.
          And, about the coconut oil, I eat a LOT of coconut oil 😉
          And I might try that onion thing tonight too!

        6. I had chronic sinus infections since young childhood. I remember snot being wiped on my sleeves from wrist to elbow, and when 1 side was full I started on the other.
          I went through life with this problem, getting a sinus infection 2x each year, being given anti-biotics at least 2x a year through my whole teen age.

          As an adult I continued to have sinus infections, but was now in America and doctors refused to give me any meds. I carried around a massive infection in my head and ear canal for 6 years before someone referred me to an Allergy Specialist.
          Blood was drawn and come to find out I had 0 anti bodies of any kind for anything outdoors because I was prematurely born and my mother never breast fed me. I was given shots for 4 years and 1 dose of last anti-biotics to kill off my very last infection.
          I am highly allergic to grass seeds ( I found out) which happen to be the relatives of GRAINS. Also, the dead bacteria in pasteurized milk mimic a virus and cause mucus accumulation in throat and sinus. I stopped consuming grains and pasteurized milk, got me grass-fed, raw milk instead and started taking fish oil…THAT together with my shots, which I’ve been off for 2 years now, was all that was needed to completely cure me of the chronic sinus infection, or ‘cold’ and flu’s in general.

          Primal now for almost 2 years and haven’t had a single infection of any kind, not even the sniffles…nada.

      2. My allergies and resulting sinus infections used to be crippling at times. Eating primal has significantly reduced them. Two products which have reduced my remaining allergies and sinus infections further are Allergy ReLeaf by Herbs, Etc. and Sinus Blaster.

        1. Arty,
          Very interesting. I actually stopped drinking milk for about 5 months now because i am nursing my second baby seems to have issues when I have dairy or so I thought. It turns out that it was something else causing her gas but cutting out dairy ended up being good for me! I was told I was allergic as a kid to milk and it always gave me bloody noses or some kind of sinus pain. But over the years I never really thought about it. And it never was THAT bad. Anyway, my husband drinks raw milk and just recently I decided id start making raw milk kefir for myself. So I started…. And that correlates to the beginning of the sinus infection. But it is raw milk, so I wonder if I really am allergic to it or it was just a coincidence. I know it’s pretty rare to have an issue with raw milk. But I’m laying off for a while anyway.
          Thanks for the comments everyone. Im starting to feel better. What an awesome community!!

  2. I’ll admit myself that some antibitoics and drugs have there place. However, I strongly believe that MOST (at least 50.00001%) have no place in this world.

    A perfect example from my own life is any and all acne drugs. I was on minocycline and then tetracycline back in the day to try and have clear skin. I hated acne but I hated these drugs more.

    They gave me headaches.

    Luckily, for me, I was never put on accutane. I’ve heard dozens of stories of people going on accutane and having phenomenal skin because of it. They get off accutane and sometimes a month, sometimes as much as a year later their acne comes back. IT COMES BACK WAY WORSE THEN BEFORE. Why? because their lifestyle is still shit. Their lifestyle is what caused acne in the first place.

    Most dermatologists want you to believe that diet has nothing to do with acne. That is complete bull shit. It’s 100% absurd.

    I think its around 40% of so of people who go on accutane go through depression. The side effects are incredibly severe. It’s harsh. Thousands commit suicide.

    It’s sad.

    I could go on and on. I’ll stop there and say, to end, that cholesterol lowering drugs are also 100% unnecessary. I think we can all agree on both of these examples. No?

    1. What ignorance – As far as cholesterol lowering drugs are concerned, you are actually insulting Grok here, not just me. Don’t you know he carried a packet of Crestor around in his loincloth? He popped a pill every time he speared a boar or chanced upon some eggs.

      😀 I’m in a silly mood tonight.

      I may be wrong, but I think accutane literally poisons your oil glands to stop them working. I know someone who got chilitis (sp?) – when your lips crack back *shudder* – because the skin gets so dry. Surely that can’t be a good thing. Not to mention the depression. And all those dishwasher-chemical-blend “cleansing” products…I’m surprised people dont get eczema from using them.

      1. You’re thinking of Cheilitis. It’s a sign of severe B-12 deficiency.

        1. Which could go hand in hand with decimation of gut flora, due to inability to properly break down and absorb food. When I reach for lip balm, my next stop is the kimchi jar.

      2. Did you read what he said? He was arguing AGAINST the use of these drugs, not for them.

        “cholesterol lowering drugs are also 100% unnecessary”

        “I strongly believe that MOST [drugs] (at least 50.00001%) have no place in this world.”

        Reading comprehension FTW.

      3. I agree that most drugs sold in the privileged parts of the developed world are unnecessary.

        However, billions of people in Africa, South America and Asia live in poverty and are threatened by lethal or crippling infectious diseases that could be cured if they could afford the correct drugs.

        The tragedy is that drugs companies can make money from drugs that treat depression, diabetes or high cholesterol, but not from drugs to cure malaria, tuberculosis, sleeping sickness or schistosomiasis. Drugs to treat these common diseases of poverty either don’t exist, or are so expensive that people can’t afford them.

        Drugs are not unnecessary – drugs are vital. The problem is our priorities.

    2. I also used to be on a bunch of acne medications (most of which were antibiotics, luckily never Accutane). When I went Primal I decided to get off of them because I started to realize how bad all these prescriptions were for me.

      Unfortunately I can’t say that the Primal diet has given me clear skin… at least not yet. My acne came back as soon as I got off the meds. But it’s a process and I would rather be healthy and live with a little acne instead of unhealthy with perfect skin.

      I wish dermatologists would start treating the issue and not just the symptoms! and the same can be said for doctors prescribing cholesterol lowering drugs!

      1. I started breaking out when I was 8 or 9, very young I know. My grandmother was horrified and dragged me to countless appointments with the dermatologist. At first it was various ointments and creams, but I was 8 or 9 and had other things on my mind than smearing my face with stuff twice a day. You know, like being a kid! So eventually, maybe thinking the ointments weren’t working, he wrote a prescription for antibiotics, which I had for YEARS. Luckily for me, again because I was a kid, I couldn’t swallow pills. So for years I cheeked them, and hid them under my mattress or in my beanbag chair. Eventually I was found out and my Nana gave up the quest.

        I am so grateful that I didn’t destroy my internal gut bacteria and mess up my immunity by actually taking the pills all those years. And I also credit having acne at a young age with making me not care as a teen. I’ve never been one to clog my pores and damage my skin with makeup, harsh cleansers, or anything else. Au natural for me, acne and all until it cleared up on its own!

        1. I gave my son’s girlfriend some of my Rozacia medicine Metrojel 1% cream. She says it works really well. Also, some people get an acne relieve from the raw egg yolk masks – ancient Indian remedy.

      2. Try putting coconut oil on your skin. Even though it’s an oil, it won’t make you break out. It will, however, help your skin deal with the Acne. See my comment above for the antibiotic properties of coconut oil Now, if I get an acute bacterial infection, I don’t depend just on coconut oil–I take antibiotics when I have to. But I avoid the necessity, most of the time, by eating coconut oil and spreading it on my skin every day.

        1. A word of caution with coconut oil as a topical treatment. I know it works for some people, but Lauric Acid is comedogenic! Olive, nigella, evening primrose, almond, etc…these oils won’t break you out for sure,be careful with coconut oil.

    3. Interesting what we will do as teenagers to get rid of acne without thinking of the long term affects.

      My brother was on acutane. He now has crohn’s disease.

      Now I’m not saying the acutane necessarily caused the Crohn’s disease directly… but I would bet it didn’t help matters any!!!!

      1. Sorry to hear about your brother. He has a tough row, that’s for sure.

        I discovered year ago that soda pop was what was causing my acne. I dawned on me the day (sorry, this is gross) a zip oozed and it was the same shade of brown as Coke. I stopped right there and have rarely touched any soda since. My face was clear in two weeks.

    4. I had a similar experience; acne 10+ years. It’s never been really bad or anything, but I’ve never been able to get rid of it and I was always told that diet affecting acne was an old wive’s tail. Once I read the Primal Blueprint and gave up lactose though, my acne has dramatically approved. I still get a little bit from time to time, and it mostly seems to correlate to how stressed out I am and if I’ve had any cheese lately.

      1. I agree with completely removing the lactose. I had no idea my acne was related to milk until I went completely primal, cut out the dairy, and my skin cleared right up. If I fall of the wagon and eat too much dairy, the acne reappears. It’s frustrating because I’ve been dealing with this for 22 years, tried numerous antibiotics, creams, etc., and it was something as simple as removing the dairy from my diet.

    5. Agreed there on the cholesterol meds, I’ve looked into that one pretty extensively, they’re especially unnecessary for women, even harmful!

      1. I went to your blog but could not leave a comment there. I just want you to know your blog is very informative and I forwarded it to some family & friends.

    6. Hi Tod,

      I took roaccutane when I was a teenager as I had bad ache, and was told I’d have dry lips, but the side effects were no biggie, as I wasn’t a woman and wasn’t pregnant… Just reading the actual list of side effects of roaccutane now, I’m amazed I got through it alive! I had severe depression as a teenager which I have to admit coincides with my taking of that medicine, though I did have it before as well, just nowhere as badly.

      Being a teenager is already difficult enough without having to fight all the problems this stuff brings. Really horrific. Thanks for your post, I never would have thought to check up about it otherwise. Some things are starting to make sense now…

  3. A year ago – before I went primal – I got a pretty bad bout of bronchitis. I was prescribed some antibiotics, but got so sick after the first tablet that I binned them. What I did was, I did hot steam inhalations with pure pine needle oil. Just 3 INHALATIONS AFTER- just 3 – I was clear of the infection.

    A few weeks ago I got an inflamed gum because of a wisdom tooth. Dentist said I had to take penicillin. I went and bought some garlic capsules, some propolis & an anti-inflammatory antioxidant complex; also, I upped my oily fish intake considerably for a week. I also got myself a tea-tree oil mouthwash (zaps the germs). Gums as good as new! My dentist’s jaw hit the floor when he heard.

    Of course, if you get something like the bubonic plague antibiotics are a good idea. [insert law-talk disclaimer about doctors & medical advice here]. But I think taking antibiotics for every little ouch isnt good.

    I may be wrong, but I think that if you take antibiotics so much, its like a crutch, your immune system kind of gets atrophied. And then the new swine/bird/shrimp flu comes along, and you’re in trouble because your very own antivirus system isnt functioning.

    Grok on everyone, and garlic rules.

    1. Garlic rules and so does coconut milk. nothing is more delicious than a berry & coconut smoothie.

        1. Coconut milk and garlic together? Why not?! Ok, maybe not… I may try it though…

          Berries and coconut milk are awesome for sure!

    2. I think so too. Our immune system is also designed to allow us to survive. That’s why we develop antibodies. Every time we get sick and then recover our body has developed the antibodies to make sure that we never get that particular strain of that bacteria or virus again. Unfortunately, bacteria are also constantly battling to survive so they are constantly mutating…hence the back and forth of get sick…..get better…get sick as we play tit-for-tat with infectious disease.

      What I think is the problem is when antibiotics are overprescribed, our natural antibodies are constantly hampered and weak. So we’re less naturally likely to fight off infection on our own. You have to work out to get your muscles stronger, right? Same principle.

      Now, like everyone here, antibiotics have saved alot of lives in the global fight on disease. But I think that’s really all they should be used to do – save lives in truly life threatening situations. I think we’d do alot better to avoid using antibiotics unless you really need them.

      1. Propolis is anti-inflammatory and immune-boosting (immunomodulatory; immune-stimulating); it also has powerful-anti-microbial and antifungal properties (it is used by bees to prevent putrification of the hive, actually). A solution is also good to use as an antiplaque (plaque buildup often causes oral infections. Though I used tea tree mouthwash, equally great)

  4. Another example of modern science treating the symptom and not the root cause… I stopped taking antibiotics when I hit 18-years-old.

  5. A large problem with medicine is the narrow look at what it does to our physiology. Life in general is holistic. You change one tiny thing and it sets off a fast falling cascade.

  6. There are some scary antibiotics out there too like levaquin. People take a few doses and tear their Achilles tendon getting out of bed. There are some crazy horror stories about that drug. I think it’s terribly irresponsible doctors prescribe this for sinus infections and uti’s.

    1. a friend of mine took some newfangled antibiotic (for a minor eye infection…dont ask why you would need antibiotics for that, I’ve no clue) and ended up getting inflamed, swollen knee joints. Nasty stuff.

      1. Maybe because infections in your face can easily and quickly move to your brain and kill you?

        1. Yeah… I had facial cellulitis once (whole left side of my face was swollen, I looked like a puffer fish) and got put on Levaquin. The nausea from the drug was bad, but in that case, I preferred not to risk the inflammation spreading to my brain. It seemed like a called-for use of antibiotics. 🙂

  7. I used to take antibiotics on at least five occasions a year to rid myself of chronic sinus infections. And then, one day, it happened. My infections dissipated. It was a month or two later I learned the correlation. The elimination of processed foods, grains, etc. were the root – duh! So when I drink a few beers too many, I know what to expect now. But even better, I now know antibiotics aren’t the solution for this body. Primal is.

  8. C. diff is very difficult to get rid of and can become chronic. I’ve had patients who’e lives were total misery because of it. But there is a new treatment that has a 91% success rate. No patient developed a subsequent recurrent infection!

    What is this miracle cure?

    Fecal transplants.

    Yup. Really.

    1. I wonder if I can make extra money selling my poop for transplants. Paleo poop has to be the best!

      1. You have a costomer! After years of being on tetracycline for acne, my gut flora have been completely decimated. I now have Celiac and Ulcerative Colitis and have seriously considered a poop transplant. My husband isn’t the ideal donor since he has mild digestive issues of his own. And my mom lives too far away. It’s hard to find a healthy poop donor, but I concur: Primal poop is the best!

    2. Im a nurse too and got c diff after being on antibiotics for the first time in like 15 years… took them for 3 days then started getting sick… c diff was awful… stopped antibiotics (was for first uti )I ended up in the hospital for dehydration and was so sick. 2 years later I still don’t think my gut is back to normal. I will be on deaths door before I ever take them again

    3. We were doing fecal transplants years ago. The doctor who prescribed them was ordering them for his critical inpatients. Everyone thought he was certifiably crazy–and he WAS, actually–but his fecal transplant patients always improved. His foil covered football helmet with the springy antennae to treat drug addictions? (Truth. Swear!) That didn’t work as well…

  9. What happened in antibiotic research is that they got lazy. For more or less ten years all research on them stopped because they thought that they had done “enough.”

    So when all these resistant strains started happening. They rushed to push out stronger antibiotics that did little and had horrible side effects.
    Lazy science makes bad medicine

  10. For the parents out there, I recently learned that 80-97% of uncomplicated ear infections clear on their own in 4-7 days. Despite this it seems that antibiotics are the routine treatment. It makes no sense! When my son had his first ear infection I told our doctor no thanks and my son was better in 6 days! It was a relief to know that I didn’t kill off his healthy bacteria. I look forward to the second installment of this series!

    1. Agreed… most children’s ear infections go away on their own anyway. So why give antibiotics??? I don’t get it at all.

      1. Because if the doctor didn’t give antibiotics and it happened to be one of the minority of cases that don’t go away by themselves, risking complications such as deafness, they’d quite rightly get their ass sued off.

    2. My son’s pediatrician caught an ear infection at a routine wellness exam. He wrote a script for an antibiotic but told us to just watch him for a few days because it would probably clear up on its own. If he seemed uncomfortable after a day or two, go ahead and fill the prescription but otherwise it would probably clear on its own. I know that they have literature now at the office saying to take a wait and see approach on the ear infections so I think this is changing.

  11. As a lifelong asthmatic I’ve had more rounds of antibiotics than I can count. When my older kids were small it was probably four to six times a year. I just kept getting bronchitis, sinus infections, laryngitis, ear infections(as an adult) and the one time the doc decided I was getting too many antibiotics and didn’t give me any, I had pneumonia in five days. I shudder to think of what my native flora look like. What finally stopped the cycle was getting rid of the husband that was keeping me in constant stress(he couldn’t hold down a job) and moving out of the house in the creek bottom to someplace dry and well ventilated. I still get bronchitis, laryngitis, sinus infections and ear infections, but not multiple times a year. Warm salt water nasal rinses blow the sinus infections out of the water before they can get started. Being careful not to overextend myself also helps. Most normal people can shake bronchitis by themselves. Strangely enough drinking a lot of water during a cold seems to make it milder.

    Despite the fact that I catch every cold coming down the way, I almost never get any kind of stomach bug or flu. I’ve had the flu twice in the last twenty years and both times it was after one of my kids puked on me.

  12. I was antibiotics for 18 months after a nasty infection. I’m sure it screwed up my gut for several years.

  13. I was on doxycycline for six months coupled with Retin-A Micro for severe acne when I was a teen. I participated in the American Cancer Society Relay for Life that year. I knew that there were warnings all over the labels stating to avoid direct sun exposure while on this medication, and so I decided to slather on some SPF 70.

    One hour in the sun and I was in such agonizing pain, I swore I was in a pot of boiling water. This sensation did not cease for 12 hours, despite my efforts and many ice cold baths. I couldn’t stand the feeling of clothing or anything touching my skin, even the skin that wasn’t exposed due to being covered up.

    That was the last time I voluntarily took any antibiotics for anything. Interestingly enough, it was shortly after these events that I was diagnosed with IBS. I wonder if there’s a connection?

    I lived with painful acne up until 6 months ago, using daily OTC exfoliants and cleansers to help combat my oily skin and infected blemishes. Once I realized that my acne is triggered by milk products and grains, it made Paleo that much easier to maintain. I won’t cheat with any type of grain due to gastrointestinal distress, but once in awhile I’ll have some type of dairy-containing dessert or artisan cheese and get 2-3 blemishes within 12 hours. But my face clears up on its own within 4 days.

    I wish we had more Primal Docs on the network. I’d really prefer to have a PCP who understands within driving distance when my wife and I decide to have children.

  14. I also took antibiotics for years for my acne. My dermatologist (even when I told her about studies saying otherwise) denied that diet or lifestyle had anything to do with my acne. I actually found the Primal Blueprint while looking for natural ways to beat my acne, because the antibiotics were making me so sick and tired. It took over 6 months of say, 90% adherence, but I’m basically 99% clear today without medication. I digest my food better, I don’t fight yeast constantly, and I have more energy. I’m just thankful I had the sense to stay away from Accutane (which my dermatologist pushed and pushed).

    1. I think one problem is that many very unhealthy people- smokers, overweight, terrible diet, etc.- still have perfect skin. So doctors extrapolate and insist that these factors can’t affect (or cause) acne for EVERYONE. But for acne prone types diet almost certainly plays a huge role.

  15. LOL at the comments talking about antibiotics atrophying your immune system. Reading such ridiculous comments made my morning.

    Source: MD

    1. Instead of ridiculing why not give a reasonably scientific explanation why this is incorrect or at least a link to further information. Readers will not simply accept your position because you have written ‘source: MD’ at the end. The idea that antibiotics weaken your natural defences does make intuitive sense after all.

  16. ahhh, I am reminded of George Carlin & his bit about our “pussification” and germophobia, etc. 🙂

  17. I understand and definitely agree that antibiotics to cure common ailments that will go away on their own or with the help of some natural supplements like fish oil are unnecessary and not advisable because of the havoc they can wreak on the immune system. However, when I was 13 I had Subacute Bacterial Endocarditis (read – Staph infection in my heart). After 3 weeks of 104.9 fever, I was hospitalized and had a catheter put in to pump antibiotics directly into my heart. Obviously I lived, although I definitely have noticed that my immune system seems weaker than most (I catch EVERYTHING!) Now, at 32, I have a 10 month old son who has had 2 Staph infections (thank God not in his heart!) The doc says that some people are just prone to certain types of infections. Anybody out there have experience with something that serious that they were able to fight off without taking antibiotics? I’m a newbie and totally unfamiliar with all things natural… such as the usefulness of garlic and fish oil, etc. One month into Primal and I have learned so much! Just wondering if anybody knows of something I should try if and when the Staph infection monster hits my household again…

    1. “The best offense is a good defense”. Find a Naturopathic Doctor and start building your immune system before it is needed. Look in the yellow pages, or go online to get a list of ND’s in your area. And eat primal.

  18. I’ve been off/on doxycyline for literally years because of my skin (sometimes for as long as 9-10 months at a time). I just got switched to a “low dose” antibiotic (still doxy, but 40mg) that supposedly is NOT antimicrobial in nature, but IS anti-inflammatory.

    The ideal is to be completely off and heal my gut, but in the meantime I’m hoping that a lower-dose will at least allow me to take probiotics and start healing some of the damage.

    1. Long term low dose accutane is much safer than long term antibiotics in my opinion. Google it- you might find the complete elimination of your acne if possible with only 10mg accutane a few times per week. All of the proven (and wildly unproven, like depression) side effects attributed to accutane virtually disappear for many low-dose users.
      I’d rather mess with my oil glands than my natural immune response. Albert Kligman (famous dermatologist) posited that sebum plays virtually no role at all given our relatively hairless modern bodies (not a good argument for primal types I admit…)

  19. I spent 4 days in the hospital just over a year ago w/ an abscess infected with MRSA. It was on my upper thigh/groin and I had a rash extending almost to my ankle. I was on a cocktail of at least 4 different antibiotics – 2 oral and 2 IV. Nasty stuff.

    I was supposed to go on a backpacking trip less than 2 weeks after I got out of the hospital (and right as I was finishing up the take-home antibiotics.) Surgeon said I was fine, Infectious Diseases doc said no way. Glad I listened to ID doc. Took probably close to two months to get… uh… everything back under control. Strictly CW at that time, so I was just eating tons of yogurt and honey.

    Not something I want to experience again. Very useful drugs, but only for rare occasions.

    1. I hit my elbow and got MRSA cellulitis. I was getting Rocephin shots but they wen’t doing any good. My wife went to the health food store and told the guy what was up and he recommended silver gel 23ppm. He said another guy he knew was in the hospital with a cellulitis infection and put some silver on it and was cured in 3 days.
      So I tried it. In 12 hours the redness and puffiness was 50% smaller. In 3 days it was gone.
      I was very grateful. I know that those type of infections can have very very bad outcomes. Now I keep some of that 23ppm silver gel at the house for scrapes etc.

  20. another side to the antibiotics issues is Flu shots…never had one, never will. our pediatrician,thankfully, agrees that they are mostly unneccessary. He said our immune systems are already taxed by all the shots! but my doctor recently asked me at least 3 times if I want a flu shot…I kept saying no, and I have been (thankfully!) healthy and mostly illness free for years…and he knows this and STILL tried to push a flu shot! beware, folks, even if you otherwise like your doctor!

    1. Antibiotics kill bacteria. Flu is a virus. There is no connection between flu vaccines and antibiotics.

      1. Also, you can’t build anti-bodies against the flu. Your giving yourself the mild flu everytime you get a shot and your body is just fighting off an invader.

        I just think flu shots are another way of getting ppl injected with something that the government wants to put into us…

        1. No, that isn’t true. You do make antibodies to the influenza virus and these do make you immune to that particular strain of the flu. Vaccines and natural infections are identical in producing strong immunity.

          You can get the flu more than once because there are many different strains of the virus. Immunity to one strain doesn’t transfer to the others.

          This is also why new strains of the flu are constantly evolving, because we are immune to the old ones and they can’t infect people any more.

  21. Penicillin saved my Grandfather’s leg after he got shot in WWII fighting hand to hand combat in the Phillipines.

    Antibiotics certainly have there place in medicine…but, like most meds that do have a legitimate purpose, they are definitely over-prescribed.

    Don’t forget, another factor in the developing of resistant strains is the use of antibiotics in CAFO operations.

    Feedlots have to use mega-doses of antibiotics to keep the animals from getting sick and dying before slaughter.

    There is some speculation that the more deadly e.coli and salmonella strains came from CAFO’s.

    1. Guess where the majority of antibiotics go in the US?

      CAFO operations. Yup, to the tune of millions of lbs a year. Much more than are used for humans.

      And they wonder why we have antibiotic resistant bacteria. Just another reason to go organic grassfed.

  22. Incredibly fascinating and extremely informative. Thanks, Mark!

  23. I had Rheumatic Fever as a child (properly diagnosed and all) — that was in the early 60s. I took “prophylactic” penn. for years thereafter. I quit for a couple of decades, then was told I needed to take a massive dose of Pen. before I got my teeth cleaned. That piece of CW lasted about 10 years. My poor gut bacteria! Those that survived are total Penicillin Resistant machines. I’m sure they pass along that resistance to nearly every other bug they meet.

    So — the good part. I don’t have a heart murmur (anymore). I didn’t die from Rheumatic Fever or get a damaged heart valve or serious myocardial sac problems.

    On the flip side — very few docs understand that you (as a person) can also become pretty resistant to the germs. I Never get any symptoms from strep. I simply carry it around and could pass it off — a kind of Streptoid Mary — so I’m very careful about getting tested whenever I might have been exposed to strep. Lucky for me (and my surviving gut bacteria) I have not tested positive in the last 20 years or so.

    All things considered, I’m very glad that penicillin-G was there for me (it wasn’t for my mom, and she spent 2 years in bed recovering from the heart effects of strep). I didn’t even miss a day of school.

    In the near future??? I think we may have run the gamut of short-term evolution in the ongoing battle of Human vs. Bacteria. MRSA is just the beginning. (Check out the resistant strains of TB out there. Not to mention the viruses like AIDS that are adapting.)

    My advice — avoid the hospital like the plague (pun intended.) Hospitals are the “perfect storm” breeding ground for the next big resistant strain.

    Coming to a Medical Center near you….

  24. I hear people say I am antibiotic resistant, they don’t work on me. I don’t think they are right. The bacteria becomes antibiotic resistant not the person.

    Antibiotics are way over used bet when you need them you need them. I had a bout a pneumonia. I did not know I had pneumonia. It severely and permanently compromised my lungs. So when you need them, don’t be stupid, use them. Just don’t use them every time you get a sniffle, a cold or the flu.

  25. Nice post, as usual. Haven’t had antibiotics prescribed for me since I went Primal. Makes sense.

    On an unrelated note, check out this new app:

    Good for those who prefer narrative over data, I suppose – wonder how it figures out what is and isn’t “healthy” for the “Healthy” meter 🙂

  26. Hi there,

    I found that things like bread, little exercise, and alcohol made my skin really bad, I tried so many things to make it better, but it was when I started eating properly, and exercising regularly that I saw a dramatic change in my skin.

    Most drugs are just a way for companies to make money, and they are not needed most of the time. Vitamin C tablets for immunity, and for infection, lavender oil or teatree. (As an aside, lavender oil is GREAT for burns!)



  27. Hi everyone,
    Antibiotic use is an issue here in Australia as well. However I have found over the years that the GP’s I have seen are more reluctant to prescribe them, I haven’t used them for years. I had surgery in 2008 (abdominal, and huge), and though I had some pretty heavy duty pain killers there was no antibiotics post op, at all. I put it down to some really good care and a private room. It’s a lottery though. Cheers

  28. For people asking for natural remedies:

    Pelargonium Sidoides, sold as “Breathe Free” by Source Naturals, has been shown to be effective for respiratory infections.

    Andrographis has been shown to reduce the severity of cold symptoms.

    Source for both claims: (a great resource for determining the efficacy of natural remedies.)

    I use andrographis every time I feel something “coming on.” I am an asthmatic who has been on pounds of antibiotics since I was a tiny kid, and used to catch everything that came near me. Primal eating and sensible exercise seem to help, and the andrographis seems to nip colds in the bud, before they get nasty and turn into secondary infections. If my breathing takes a turn for the worse I take some Pelargonium syrup a few times a day, and it usually helps.

  29. well thanks for that post, I take between 10 and 15 different antibiotic treatments myself each year and now have to take antifungus medication… my gut flora is weak and therefore the bad bacteria have all the power they need to multiply. I believe all these treatments to have been completely unnecessary most of the time, the only purpose being to take little risks and feed me back to the workplace after 3 days of rest only… I used to be sick once a year, now I’m not sick about once a year… disgusting

  30. What about all the antibacterial hand wash, kitchen wipes, baby wipes etc? Totally unnecessary (if they are actually effective and not just a gimmick) and probably harmful for those who use them. You can never develop your own natural resistance to bugs if you try and kill them at every turn.

  31. I prefer prevention over cure and if you do get ill, natural remedies over antibiotics. But ye antibiotics are extremely helpful but when people don’t finish their prescription, it can lead to antibiotic resistance.

  32. This is one of my all-time favorite topics. Horizontal gene transfer in bacteria was the subject of a recent research paper:
    This wired blog covered research on how taking antibiotics can permanently destroy your good gut bacteria. Scary.

    I’m currently kind of obsessed by the human gut biome, and wrote about it in a post on research about the gut biome and mental health here:
    and about fecal transplants as a possible solution for C. difficile and IBD here:

    Sorry for all the links. Mark, bravo for tacking a fantastic and super-important topic!! I can’t wait to read installment # 2.

  33. Dear Mark,

    Thank you for your interesting article. I’m looking forward to your article on the other side of the debate: antibiotic addiction/dependence. I’m not a doctor, but I believe that overprescription of antibiotics may at some point prevent the organism to fight the bacteria through its OWN defense mechanisms. From 2008 to 2010, I suffered from repetitive sore throats and had to take antibiotics about 10-15 times/year. In 2010 I had a tonsillectomy and since then (touch wood), not a single sore throat and no single pill of penicillin. However, I believe I could have avoided this operation if doctors in France didn’t prescribe antibiotics automatically for sore throat! Best.


  34. Expecting parents: don’t forget that the best way to keep kids off antibiotics when they’re little and grown is to breastfeed for 2 years (world health organization ). It wont prevent every case of needing antibiotics… but most. My 6 year old has never had antibiotic…. my 4 year old did once. Most of my friends who nurse that long have similarexperience… guys… encourage your wives/girlfriends to do this…. doesn’t get anymore primal than that!

  35. I’ve recently read much about hydrogen peroxide and oxygen therapies.
    They are supposed to cure colds and infections way better than anything a doctor can prescribe.

    Google it.

  36. I have been on and off antibiotics for years for different reasons. Most of the time my mom, who is a nurse, wanted to ‘help’ and that is how she saw she could. No parent wants to see their kid in pain. And in the 80’s and 90’s living a ‘primal’ like was out of the question.

    Anyways when I moved away from home whenever I got sick I would break out leftover antibiotics from a previous bout of something (I had a little bit of everything, from seeing the DR so much) too help speed recovery. And it used to work.
    Since I started eating primal foods I have been getting sick a lot less, like practically never, and the one time I have gotten sick this year, what previously would have turned from a cold into bronchitis, is just a cold and went away in 7 days.

    Primal is beautiful. Don’t stop!!

  37. Okay so I have a question… If antibiotics fatten up livestock, do they make humans fat too?

    Are they the same kind of antibiotics? How do antibiotics work to fatten livestock or make them grow rapidly?

    1. The antibiotic is used to keep the sick cow alive as they are filling it with grain. The grain makes it gain weight. Cows are rumins and are not adapted to eating grain but rather to eat grass and the like. The diet and close quarters stress the animal In several ways. Many would die before reaching the goal weight if not for the antibiotics.

  38. I feel like too many doctors hand out Z-packs like they are candy. If you use Z-packs too often you open yourself up to much more threatening strands of viruses due to a weaker immune system that relied on Z-packs to bail them out.

  39. I watched a documentary on phages as a much older (in terms of use) alternative to antibiotics. The doc was filmed in the country of Georgia where they had phages from over 100 years ago. They “grow” them and then use them whenever there are outbreaks in their hospitals. Apparently, the Georgian population uses very few antibiotics.

    The doc was called, “Phages the Virus that Cures”. It was fascinating. (Apparently Time magazine did an article on phages a while back.)

  40. For those looking at strengthen their immune systems using (semi-)natural approaches going beyond just food and foodstuffs, the information and referenced supplements in this Life Extension Foundation article may be of use:

    My father recently contacted c.diff. while in the hospital. It came back after he went off the antibiotics. After he gets off this time I will be heavily dosing him with pre- and probiotics, and trying out some of the suggestions.

  41. I got bitten by what I think was a tick on the east coast last week and I’m wondering if this is an instance where taking antibiotics are a no-brainer. I know a girl with Lyme disease and I do NOT want what she has, and I’m scared enough to take antibiotics, although I’m still doing lots of research. Everything about Lyme disease on the internet says do a prophylactic treatment of antibiotics for 3+ weeks immediately after the bite, seeing as, apparently, 50% of tick bites carry Lyme on the East coast. I don’t see anywhere on this blog where it talks about dealing with a potential lyme bite with alternative foods. Will I be safe to take the antibiotics while also eating a lot of probiotic foods like kimchi, kefir, and garlic to replenish the flora in my gut?