A gut reaction

The development of antibiotics is one of the greatest advances of modern medicine. While antibiotics have dramatically improved morbidity and mortality rates worldwide, current evidence asserts that one should err on the side of caution when prescribing antibiotics. The medical literature is accumulating studies on alarming consequences of inappropriate antibiotic use. Due to antibiotic overexposure, a North American “hypervirulant” strain of Clostridium difficile has emerged causing more severe gastrointestinal manifestations than previous strains. More recently, antibiotic overuse has been associated with obesity and diabetes mellitus. Unnecessary antibiotic use has led to increasing rates of bacterial resistance rendering more antibiotics ineffective. We are currently on the brink of an era which could reverse all the progress made with the introduction of antibiotics. The salient health consequences of inappropriate antibiotic prescriptions and the threat of a postantibiotic era command attention to practical initiatives that improve antibiotic prescribing patterns.