Antibiotics play an important role in medicine, but as you may already know, the CDC states that they are frequently overused: up to 50% of antibiotic prescriptions are not optimal or effective.1 Systemic effects are particularly dramatic when antibiotics are given to infants, and research suggests that the effects of antibiotics on the pediatric microbiome can persist into adulthood.2 Recent research shows that frequent antibiotic use in childhood may increase the likelihood of a variety of conditions, such as allergies,3 asthma,4,5 atopic disorders, autoimmune disorders, obesity, and infections.2 It also appears that some of the effects of antibiotic exposure depend on genetic susceptibility.6
Gathering a complete patient history for those with chronic diseases should include asking patients about their early antibiotic exposure—especially for patients with allergy, autoimmunity, and obesity. When you know that early antibiotic exposure is an underlying factor in a patient’s chronic dysfunction, you can address the root cause with a treatment plan that helps to reestablish balance among the gut microflora. This can often mean the difference between restoring a patient to wellness and years of ongoing chronic issues.
Early childhood antibiotics are only one of a range of early life factors that affect health throughout adulthood. Collecting and interpreting this information can become part of your daily clinical practice, and IFM can help by providing a suite of patient-focused forms to gather, organize, and interpret early life and current health information.
Focusing on why patients have their particular symptoms and treating the root cause can change your perspective. Mark Hyman, MD, director of Cleveland Clinic Center for Functional Medicine and IFM board president of clinical affairs, shares his perspective on the detailed patient history as a key element of treatment:
Applying Functional Medicine in Clinical Practice (AFMCP), IFM’s five-day premier training course, gives you hands-on experience using these forms and interpreting the data. You’ll walk out the door with patient assessment and intake forms that allow you to uncover the underlying causes of your patients’ chronic conditions and tailor your treatments to their specific needs.
- Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. CDC. http://www.cdc.gov/drugresistance/threat-report-2013/pdf/ar-threats-2013-508.pdf. Published 2013. Accessed September 2, 2016.
- Vangay P, Ward T, Gerber JS, Knights D. Antibiotics, pediatric dysbiosis, and disease. Cell Host Microbe. 2015;17(5):553-64. doi:10.1016/j.chom.2015.04.006.
- Fouhy F, Guinane CM, Hussey S, et al. High-throughput sequencing reveals the incomplete, short-term recovery of infant gut microbiota following parenteral antibiotic treatment with ampicillin and gentamicin. Antimicrob Agents Chemother. 2012;56(11):5811-20. doi:10.1128/AAC.00789-12.
- Risnes KR, Belanger K, Murk W, Bracken MB. Antibiotic exposure by 6 months and asthma and allergy at 6 years: findings in a cohort of 1,401 US children. Am J Epidemiol. 2011;173(3):310-18. doi:10.1093/aje/kwq400.
- Russell SL, Gold MJ, Hartmann M, et al. Early life antibiotic-driven changes in microbiota enhance susceptibility to allergic asthma. EMBO Rep. 2012;13(5):440-47. doi:10.1038/embor.2012.32.
- Lee E, Kwon JW, Kim HB, et al. Association between antibiotic exposure, bronchiolitis, and TLR4 (rs1927911) polymorphisms in childhood asthma. Allergy Asthma Immunol Res. 2015;7(2):167-74. doi:10.4168/aair.2015.7.2.167.