Is it true that antibiotics reduce immunity and kill microflora: pharmacologist Elena Trubacheva dispels popular myths

Antibiotics are medicines that kill bacteria or stop them from multiplying. As a result, the colony of microbes dies, and the person it attacked has an excellent chance of recovering soon. It would seem that everything is simple: these are the necessary drugs and an excellent tool for doctors. But there are many enduring myths around antibiotics.

Clinical pharmacologist Elena Trubacheva told, which should not be feared by patients to whom the doctor has prescribed these drugs. The recording of the lecture is posted on the YouTube channel of the project "ANTROPOGENESIS.RU" - the organizer of the forum "Scientists against myths". Lifehacker made a summary of the speech.

Antibiotics are drugs that researchers study only on colonies of microbes in a petri dish. But more complex processes occur in the human body, so doctors in practice have to take into account many different factors that affect the effectiveness of the drug. There are many myths that

antibiotics look terrible and incomprehensible drugs. Let's analyze the most popular of them.

Myth 1. Antibiotics are unpredictable and it's best to avoid them altogether.

Antibacterial drugs are really dangerous, but only for microbes: drugs kill them. But people are not threatened by the drugs themselves, but by their incorrect prescription. Here the myth becomes true: the uncontrolled use of antibiotics can indeed lead to unpredictable results.

There are several extremes that can greatly harm outpatients.

Access to antibiotics without any restrictions is really dangerous

This is a situation where anyone can buy any antimicrobial drug in a pharmacy. As a result, both doctors and patients get only new problems.

Here is an example. There is such a group of antibiotics - carbapenems. These are one of the most powerful drugs that can seriously help even with sepsis.

Uncontrolled access to these drugs led to the fact that in Bombay 12 years ago, especially protected E. coli appeared in the sewers. Enzymes were found in them that are capable of destroying all known types of antibiotics in general.

The main problem is that these sticks from Bombay have made their way to other parts of the world. They also reached our country. Doctors struggle with them, but sometimes patients appear in various clinics who suffer from relatives of those same Bombay microbes. Such pathogens lead to a serious condition of the patient and greatly complicate the work of specialists.

Incorrect prescription of drugs can harm

Unfortunately, this is not uncommon. It is after such an experience that people who have received a completely different result than they expected, begin to be afraid of any antibiotics.

For example, a doctor may prescribe a drug that has no effect on the main pathogen that caused the disease, but destroys all other microbes. As a result, the main "enemy", left without competitors, feels great and begins to actively multiply. And the disease goes into a more severe stage.

Another example shows how patients can hurt yourself. A common case: the doctor prescribed antibiotics for a certain period, for example 10 days. But the patient stops doing it earlier. Or vice versa: the doctor prescribes pills after a cycle of intravenous injections. But for some reason, the patient believes that droppers are definitely more effective, and does not fulfill the appointment to switch to pills.

In both cases, the situation develops according to a similar scenario. Symptoms diseases recede, but surviving pathogenic microbes still remain in the body. As soon as the directed action of the antibiotic stops, these individuals immediately begin to multiply and give birth to a new colony of microorganisms.

For patients who are accustomed to accurately follow all the recommendations, an important question arises: what to do if you are afraid of the wrong appointment. There is only one answer: go to your clinic or other medical institution and look for a clinical pharmacologist. It is this specialist who will help you figure out if everything is in order with the appointment. antibacterial drugs.

Complete refusal of antibiotics can lead to serious consequences.

When a person categorically refuses to take antimicrobial drugs, his body is left alone with pathogens. If the disease is severe, the immune system may not be able to fight the infection. The outcome can be anything, up to lethal. Therefore, you should not refuse the prescribed course of treatment.

Myth 2. Antibiotics lower immunity

No, antibiotics do not affect the immune system. Let's see what happens to her during a pathogen attack.

When dangerous microbes enter the body, a mechanism is activated that doctors call a non-specific immune response. To the colony of pathogens rush leukocytes and begin to destroy enemies. As a result, these protective cells die along with the pathogens.

If the source of infection is on the surface of the skin - for example, in the form of a small scratch - you can easily destroy some of the microbes with an antiseptic. Then the leukocytes will have less work to do. The patient will notice this, because there will be very little pus at the site of injury - that is, those leukocytes that have completed their mission and died. If the wound is very small, the immune system easily cope with its task - neutralize microbes and eliminate the threat.

Now imagine that a large colony of pathogens has entered the body. To cope with them, their populations need to be reduced. Or make it so that the microbes stop multiplying - then it will be easier for the body to neutralize the pests that have already penetrated. Otherwise, leukocytes may not be able to cope and lose, and the immune system will send more and more batches of fighters against microbes to the place of the fight.

As a result, an unpleasant situation arises. For example, in inflammation maxillary sinuses we get a graveyard of waste white blood cells in the form of pus, swelling and serious inflammation. And the immune system is not able to cope with all this.

Let's add antibiotics. They will drastically reduce the population of pathogens. This means that they will allow the immune system to start working again at its usual rhythm, cope with the current threat and be able to fight new pests.

Myth 3. Antibiotics quickly kill the intestinal microflora

The popular myth that antibiotics will certainly cause dangerous dysbacteriosis is created by the so-called big pharma. More specifically, the producers of probiotics.

Again we will talk about typical situations that everyone can face. For example, a person fell ill, and the doctor prescribed him a course of antibacterial drugs lasting 7–10 days.

In the intestines of each of us live bacteria with a total weight of about 2-3 kg. And in one or a week and a half it is impossible to kill and clean out all this mass. It's just not possible.

But if you drink antibacterial drugs for years (alas, this also happens, albeit extremely rarely), we will see the effect that we have already talked about before. One type of bacteria, and usually the most pathogenic, will receive a selective advantage. All useful microflora severely affected by antibiotics. But some anaerobic bacteria will feel great, and it will be much more difficult to deal with them.

The same effect can be obtained if you stop a course of antibiotics without finishing it. A strain can grow in the intestines that this drug will not harm in the future.

Yes, there are indeed situations when a person who takes antibiotics has diarrhea. But it's not dysbacteriosis. As a rule, this is how irritation of special motilin receptors in intestines. This irritation is usually caused not by the antibiotics themselves, but by the accompanying substances in the tablets.

Of course, this does not mean that the doctor should not pay attention to unpleasant symptoms. Definitely worth it, especially if the patient has been treated for a long time and for several diseases. But each such case must be analyzed specifically and carefully study all the accompanying circumstances. And do not write off everything for dysbacteriosis and do not prescribe thoughtlessly probiotics.

Myth 4. Antibiotics Weaken

This is not true, because we have neither strong nor weak antibiotics in our arsenal. But there is an incorrect use of antibacterial drugs. This happens if the doctor chooses the wrong medicine, prescribes the wrong dose and makes mistakes in the timing of treatment.

As a rule, after 48 or 72 hours after starting the antibiotic, the patient should experience relief. If he doesn't quit drink the prescribed pills, after some time, the clinical indicators also normalize - that is, the results of the tests will also show recovery. It happens that after the first 48-72 hours nothing happens. Then the doctor must change the drug and again observe the reaction of the body.

Unfortunately, another sad situation often occurs. Some doctors try to apply the same medicine against all pathogens at once. This is how penicillin was once used.

Success in the fight against the disease depends on the doctor, and not on the "strong" or "weak" antibiotic.

Myth 5. Antibiotics are useful in fighting viruses

This myth has emerged and intensified during the fight against COVID-19. Yes, antibiotics were prescribed everywhere during the pandemic for some reason. Some doctors continue to do this today. But, despite the huge number of appointments of such drugs, they do not affect viruses. And the coronavirus as well.

Maybe during the pandemic, such a scenario arose. Inflammation of the lungs is often treated with antibiotics, and COVID-19 often led to pneumonia. So the doctors prescribed antibiotics.

The problem is that the coronavirus did not cause bacterial pneumonia, but a viral one. And if the doctor is afraid of bacterial pneumonia in a serious patient, he must prescribe an antibiotic. Moreover, if there are serious suspicions that the patient is threatened pneumonia it is of a bacterial nature, the doctor must first prescribe an antibacterial drug, and then collect the necessary tests.

If the appointment is made on time, the doctor manages to save the patient or greatly reduce the severity of the disease. But antibiotics won't help with viral infections.

Learn how to properly handle antibiotics. First of all, this applies to doctors. But patients should also know what to expect from antibacterial drugs. And understand in what cases it is worth consulting not only with a therapist, but also with a clinical pharmacologist.